Mal de debarquement (or mal de dÃÆ' Â © barquement ) syndrome ( MdDS , or the common name disembarkment syndrome ) is a neurological condition that usually occurs after a cruise, aircraft, or other ongoing motion event. The phrase "mal de dÃÆ' Â © barquement" is French and translates to "disembarated disease". MdDS is usually diagnosed by a neurologist or ear nose & amp; a throat specialist when someone reports feelings of rocking, swinging, or swinging (though they are not always rocking). This usually follows a voyage or other motion experience. Because most vestibular tests prove negative, doctors may be confused when they try to diagnose the syndrome. The main diagnostic indicator is that most patients feel better when driving or driving a car, namely: when in passive motion. MdDS can not be explained by the structural brain or inner ear pathology and is most commonly associated with movement triggers, although it may occur spontaneously. This is different from the general condition of "land diseases" that most people feel in the immediate aftermath of a motion show like a boat cruise, a plane ride, or even a treadmill routine that may last only a few minutes to several hours. This syndrome has recently received increased attention because of the number of people present with the condition and more scientific research has begun to determine what triggers MdDS and how to cure it.
Video Mal de debarquement
Symptoms
The most commonly reported common symptoms including persistent motion sensations are usually described as rocking, swinging, or oscillating, an imbalance with difficulty maintaining balance; it is rarely accompanied by a true spinning vertigo. Ridiculous tired, the patient can become tired quickly with minimal exertion and experience neck and back pain. Other symptoms include a feeling of pressure in the brain, mostly around the frontal lobe area, headache and/or migraine headaches, ophthalmodynia periodica, earache, full ears and possibly tinnitus.
Weather fluctuations also affect, especially hot weather and changes in air pressure. Many have photo sensitivity and find it more difficult to walk in darkness and other sensitivity to strong odors including chemical odors. Cognitive impairment ("brain fog") includes the inability to remember words, short-term memory loss, inability to multi-task, misspelling and mispronunciation, difficulty concentrating. Many people with MDDS report that they can not use computers for long periods of time because of visual stimulation, and some can not even watch television.
Symptoms can be increased with stress, lack of sleep, crowds, flashing lights, loud noises, rapid or sudden movement, closed areas and visual intolerance of busy patterns and rolling motions.
Patients with MDDS may develop hypersomnia and can sleep up to 12 hours or more in a day, depending on their level of symptoms. The study revealed that MDDS was not associated with migraine and many patients had never experienced migraine symptoms before the onset of the disorder. However, for some patients with MDDS there may be a correlation between migraines and some pathophysiologic overlaps or even other triggering diseases.
This condition may be masked by the return of movements such as in cars, trains, planes, or boats; however, once the movement stops, the symptoms will return or return, often to a much higher level than when the journey first began.
The symptoms of MdDS may be very debilitating and fluctuate high and low every day; it greatly affects the work capacity of the sufferer with many having to let go of the job; it also limits most of the day-to-day and other social activities. Patients can have a low quality of life both in the physical and emotional realms, comparable to people who have multiple sclerosis with many similar symptoms.
Persistent MdDS
In persistent MdDS, symptoms continue indefinitely without remission. The longer the disturbance persists, there is less chance of remission. All medical treatments are palliative for patients with persistent chronic MDSDS symptoms.
Maps Mal de debarquement
Diagnosis
MdDS is diagnosed in several ways, one with symptoms: in particular, "constant wobble, swinging feeling" and the reduction of this feeling as it moves again and as an exclusion problem. There is no definitive test that confirms MDDS, only tests that override other conditions. Tests include hearing and balance, and MdDS is commonly diagnosed by neurologists or ear, nose, and throat specialists.
Treatment
There is no known cure for MdDS, such as balance and walking disorder, some form of transfer exercise is considered helpful (eg walking, jogging, or cycling but not on a treadmill or stationary bike). This has not been well studied in MDDS. Drugs that suppress nerves and brain circuits involved in balance (eg, benzodiazepine clonazepam) have been noted to help and may decrease symptoms; However, this is not a cure. It is not known whether drugs that suppress symptoms prolong the duration of symptoms or not. Vestibular therapy has not been proven effective in treating MdDS.
Additional research is being done into the neurological nature of this syndrome through imaging. This disorder remains incurable and permanent if symptoms do not disappear in a short period of time.
Epidemiology
This condition is considered less reported in the medical literature. A study of 27 cases conducted by Timothy C Hain in 1999 recorded all but one patient being female. The average age in this series is 49 years. This clear gender gap, however, may be due in part to the fact that the questionnaire on which this research is based is circulated in a publication with a predominantly female reader base.
Subsequent research has produced conflicting results with respect to the gender distribution of MDDS. The trend in the Hain report was recently supported by the MDDS BalanceDisaster Foundation, in a study of more than 100 people diagnosed with MDDS. Ratio of women: men is about 9: 1; the average age of onset is 43-45 years. However, another recent study found that 44% of subjects who had experienced MdDS for 2 years or more were men, showing a more equitable distribution.
It has been proven to occur on a journey of as little as 30 minutes although it has been unclear how long it takes for the symptoms to occur. The most frequently reported inciting incident was prolonged sea shipping (~ 45%); However, shorter boating trips (~ 22%), airplane travel (~ 15%), and car travel (~ 8%) have all been described.
Mal de DÃÆ'Ã… © barquement syndrome has been noted as far back to the time of Erasmus Darwin in 1796, and Irwin J A (1881) "The seasick pathology".
Cases of MdDS have been reported in children as young as eight years and in both sexes. Men may have a more difficult time getting a diagnosis because of reported female disparities. When sailors and soldiers returned from World War II, this syndrome was reported at a higher rate in men.
Research study
Repetitive transcranial magnetic stimulation
Although MDDS causes significant disability, treatment for MDS remains non-existent. A pilot study has begun to take advantage of this repetitive transcranial magnetic stimulation (rTMS) into a method of neuromodulation in which a local magnetic field is applied over the scalp to induce an electric current in the cortical structure underlying the coil. Low frequency RTM (e1 Hz) induces local inhibition, whereas high frequency RTM (Q5 Hz) induces local stimulation. TMS studies have been shown to be helpful in reducing MdDS symptoms if treatment is ongoing; However, this is not a cure.
Vestibulo-Ocular Reflection 2014
At least one clinical trial on readaptation of the vestibulo-ocular reflex performed by Dr Mingjia Dai of Mount Sinai Hospital in New York City has yielded results for a significant percentage of patients who have participated in the program.
Dr. Dai has developed interventions that provide symptomatic improvement for 70% of patients in the clinical trial phase. The protocol involves the physical manipulation of the patient intended to readapt the vestibulo-ocular reflex. While the program is no longer in the research phase, Dai continues to receive patients. According to Dai, "success" was measured as a 50% reduction in symptoms.
Recent studies have shown a very small percentage of cases of MDDS may be associated with optokinetic nystagmus (OKN).
See also
- motion sickness (seasickness, motion sickness)
- Space adaptation syndrome (Space flight "zero-g" and back)
References
Source of the article : Wikipedia
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