How is Mal de debarquement diagnosed?

Diagnosis of Mal de Debarquement

Mal de Debarquement (MdDS) is a rare neurological disorder characterized by a persistent sensation of rocking, swaying, or bobbing, typically experienced after a period of motion such as a boat or plane ride. The diagnosis of MdDS can be challenging as it is a subjective experience and there are no specific tests or biomarkers available to confirm the condition. However, healthcare professionals use a combination of clinical evaluation, medical history, and exclusion of other possible causes to diagnose MdDS.

Clinical Evaluation

The first step in diagnosing MdDS is a thorough clinical evaluation by a healthcare professional. The doctor will review the patient's medical history, including any recent travel or exposure to motion, and ask about the specific symptoms experienced. The characteristic symptom of MdDS is a persistent sensation of motion, typically described as rocking, swaying, or bobbing, that continues for an extended period (usually weeks to months) after the motion exposure. The doctor will also inquire about any associated symptoms such as dizziness, imbalance, or cognitive difficulties.

Exclusion of Other Causes

Since the symptoms of MdDS can overlap with other conditions, it is important to exclude other possible causes before confirming the diagnosis. The doctor will perform a comprehensive physical examination to rule out any underlying medical conditions that may be responsible for the symptoms. This may include tests to assess balance, coordination, and neurological function.

Additionally, the doctor may order specific tests to exclude other conditions that can cause similar symptoms, such as vestibular disorders, migraines, or inner ear abnormalities. These tests may include:

• Vestibular Function Tests: These tests evaluate the function of the inner ear and the vestibular system, which is responsible for maintaining balance and spatial orientation. They may include electronystagmography (ENG), videonystagmography (VNG), or rotary chair testing.


• Imaging Studies: Magnetic resonance imaging (MRI) or computed tomography (CT) scans may be ordered to rule out structural abnormalities in the brain or inner ear.


• Blood Tests: Blood tests may be conducted to check for any underlying metabolic or hormonal imbalances that could contribute to the symptoms.

Diagnostic Criteria

While there are no specific diagnostic tests for MdDS, there are certain criteria that can help in confirming the diagnosis. The criteria proposed by the MdDS Balance Disorder Foundation include:

• History: A history of exposure to motion, such as a boat or plane ride, preceding the onset of symptoms.


• Symptoms: A persistent sensation of rocking, swaying, or bobbing that lasts for an extended period (usually weeks to months) after the motion exposure.


• Exclusion of Other Causes: Other possible causes of the symptoms, such as vestibular disorders or migraines, have been ruled out through appropriate clinical evaluation and tests.

It is important to note that the diagnosis of MdDS is primarily based on clinical judgment and the exclusion of other possible causes. The subjective nature of the symptoms and the lack of specific diagnostic tests make it a challenging condition to diagnose definitively.

Seeking Medical Help

If you are experiencing persistent symptoms of rocking, swaying, or bobbing after a period of motion, it is important to seek medical help. A healthcare professional, such as a neurologist or an otolaryngologist, can evaluate your symptoms, perform the necessary tests, and provide an accurate diagnosis. Early diagnosis and appropriate management can help alleviate the symptoms and improve your quality of life.