Mal de Debarquement Syndrome (MdDS)

Mal de Debarquement Syndrome (MdDS), French for “sickness of disembarkment”, is a disorder in which a person experiences a persistent sensation of rocking, swaying, or bobbing — as if still on a boat — after exposure to motion. It most commonly follows a cruise, flight, or long car journey, but can also occur spontaneously.

Understanding MdDS

During travel, the brain adapts to constant motion. In MdDS, this adaptation fails to “switch off” once the motion has stopped, leaving a persistent internal sense of movement. Unlike typical vertigo, the sensation is one of self-motion rather than spinning.

Signs and Symptoms

• A persistent feeling of rocking, swaying, or bobbing
• Symptoms that often improve while in motion (e.g. driving) and worsen when still
• Unsteadiness and difficulty with balance
• Fatigue, brain fog, and reduced concentration
• Sensitivity to busy visual environments
• Symptoms that can persist for weeks, months, or longer

Common Triggers

• Cruises and boat travel (most common)
• Air or long car travel
• Sometimes spontaneous onset without a clear trigger

Assessment

Our vestibular physiotherapists carefully assess to:

• Distinguish MdDS from other vestibular disorders (BPPV, vestibular migraine, PPPD)
• Characterise the rocking sensation and its triggers
• Evaluate balance and gaze stability
• Identify aggravating and easing factors

Because MdDS shares features with other conditions, accurate assessment is important to guide the right treatment.

Physiotherapy Treatment

Vestibular Rehabilitation

• Habituation exercises to reduce the rocking sensation
• Balance retraining and gaze stability work
• Graded exposure to provoking environments
• Strategies tailored to your symptom pattern

Education and Self-Management

• Understanding the condition and its course
• Managing symptom flare-ups
• Reducing visual and motion sensitivity
• Coordinating with medical specialists where appropriate

Outlook

Some cases of MdDS settle on their own, while others persist and benefit from structured rehabilitation and management. Treatment focuses on reducing symptom intensity, improving balance and function, and supporting return to normal daily activities.

Expected Outcomes

Many people experience meaningful improvement in the rocking sensation, balance, and daily function with vestibular rehabilitation and a clear self-management plan.