title: Management of mal de debarquement syndrome as vestibular migraines.
abstract: Mal de debarquement syndrome (MdDS) is a balance disorder that typically starts after an extended exposure to passive motion, such as a boat or plane ride. Management is typically supportive (e.g. physical therapy), and symptoms that persist beyond 6 months have been described as unlikely to remit. This study was conducted to evaluate the response of patients with MdDS to management with migraine prophylaxis, including lifestyle changes and medical therapy.
  
  
  
  Prospective review.
  
  
  
  Ambulatory setting at a tertiary care medical center.
  
  
  
  Clinical history, detailed questionnaires, and audiograms were used to diagnose patients with MdDS. Those patients with the diagnosis of the MdDS were placed on our institutional vestibular migraine management protocol. Treatment response was assessed with a quality-of-life (QOL) survey and visual analog scale.
  
  
  
  Fifteen patients were diagnosed with MdDS, with a predominance of females (73%) and a mean age of 50 ± 13 years. Eleven patients (73%) responded well to management with a vestibular migraine protocol, which included lifestyle changes, as well as pharmacotherapy with verapamil, nortriptyline, topiramate, or a combination thereof. In comparison, a retrospective control group of 17 patients demonstrated a lower rate of improvement when treated with vestibular rehabilitation and physical therapy.
  
  
  
  Management of MdDS as vestibular migraine can improve patients' symptoms and increase the QOL. Nearly all the patients suffering from MdDS had a personal or family history of migraine headaches or had signs or symptoms suggestive of atypical migraine.
  
  
  
  4 Laryngoscope, 127:1670-1675, 2017.
authors.affiliation: Division of Otology, Neurotology, and Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Irvine, California, U.S.A.
authors.forename: Yaser
authors.initials: Y
authors.lastname: Ghavami
authors.affiliation: Division of Otology, Neurotology, and Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Irvine, California, U.S.A.
authors.forename: Yarah M
authors.initials: YM
authors.lastname: Haidar
authors.affiliation: Division of Otology, Neurotology, and Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Irvine, California, U.S.A.
authors.forename: Kasra N
authors.initials: KN
authors.lastname: Ziai
authors.affiliation: Division of Otology, Neurotology, and Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Irvine, California, U.S.A.
authors.forename: Omid
authors.initials: O
authors.lastname: Moshtaghi
authors.affiliation: Division of Otology, Neurotology, and Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Irvine, California, U.S.A.
authors.forename: Jay
authors.initials: J
authors.lastname: Bhatt
authors.affiliation: Division of Otology, Neurotology, and Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Irvine, California, U.S.A.
authors.forename: Harrison W
authors.initials: HW
authors.lastname: Lin
authors.affiliation: Division of Otology, Neurotology, and Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Irvine, California, U.S.A.|Department of Biomedical Engineering, University of California, Irvine, Irvine, California, U.S.A.
authors.forename: Hamid R
authors.initials: HR
authors.lastname: Djalilian
mesh_terms: D000328:Adult; D000368:Aged; D004359:Drug Therapy, Combination; D005260:Female; D005632:Fructose / Q000031:analogs & derivatives* / Q000627:therapeutic use; D020022:Genetic Predisposition to Disease / Q000235:genetics; D006801:Humans; D008297:Male; D008575:Meniere Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics; D008875:Middle Aged; D008881:Migraine Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics; D009041:Motion Sickness / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics; D009661:Nortriptyline / Q000627:therapeutic use*; D011446:Prospective Studies; D011788:Quality of Life; D000077236:Topiramate; D014195:Travel; D000076082:Travel-Related Illness; D014700:Verapamil / Q000627:therapeutic use*; D064232:Visual Analog Scale
chemical_list: D000077236:Topiramate; D005632:Fructose; D009661:Nortriptyline; D014700:Verapamil
keywords: MdDS; mal de debarquement syndrome; quality of life; vestibular migraine