May 06, 2020
The First Attack of Vertigo – Is it a Stroke or is it Inner Ear Disease?
Motion Sickness and Persistent Sea Sickness
Motion sickness, also called sea sickness, occurs when your brain receives conflicting signals from eyes, inner ears, skin and joints about your state of motion.
The symptoms of motion sickness include dizziness, sweating, nausea, and vomiting.
People who suffer from migraine are more likely to suffer from motion sickness.
On a ship: Choose a cabin in the middle of the ship and near the waterline. When on board, go up on deck and focus on the horizon.
In an airplane: Request a window seat and look out the window. A seat over the front edge of the wing is the most preferable spot (the degree of motion is the lowest here). Direct the air vent to blow cool air on your face.
On a train: Always face forward and sit near a window.
In a car: Sit in the front seat; if you are the passenger, look at the scenery in the distance. For some people, driving the vehicle (rather than being a passenger) is an instant remedy.
Do not read or look at your phone in a moving vehicle. If you are prone to motion sickness, reading or looking at your phone is likely to make it worse.
Get plenty of rest. Get a good night’s sleep the evening before you travel. Being overtired can make you more susceptible to motion sickness.
Avoid greasy or acidic foods. Avoid heavy, greasy, and acidic foods in the hours before you travel.
Drink plenty of water
Do not drink large amounts of alcohol the evening before you travel. Alcohol speeds up dehydration and generally lowers your body’s resistance to motion sickness, if you are prone to it.
Stand if you feel queasy. Stand up, if you can, and look out over the horizon. Despite what you might think, sitting or lying down actually may make you feel worse.
Don’t smoke and avoid others who smoke.
Eat dry food. Dry crackers may help settle a queasy stomach.
Use the seat head rest. Lean your head against the back of the seat or head rest when traveling in vehicles with seats to minimize head movements.
Avoid others who have become nauseous with motion sickness. Seeing and smelling others who have motion sickness may cause you to become sick.
Medication and other treatments
Motion sickness can be treated with over-the-counter and prescription medicines.
Over-the-counter medicines: Antihistamines are commonly used both to prevent and treat motion sickness an example being Cinnarizine (Stugeron) 30mg taken 2 hours before travel and then 15mg every 8 hours if required, dose to be taken during journey. The side effect of these medications is drowsiness
Prescription medicines: A review suggested the most effective treatment appears to be scopolamine – also known as Hyoscine (https://www.uspharmacist.com/article/the-pharmacologic-management-of-motion-sickness).
Scopoderm patches (hyoscine 1.5mg) medicated self adhesive patches taken 5 to 6 hours before travel for the control of travel sickness – effective for 72 hours on a patch ( https://www.doctorfox.co.uk/travel-sickness/scopoderm.html & https://www.medicines.org.uk/emc/product/3276). Scopolamine may create an annoying dry mouth side effect. Certain patients with glaucoma and other health problems should not use this drug.
The above hyperlinks discuss all aspects of this medication including side-effects etc.
Nonpharmaceutical remedies: Numerous non-medicine options have been promoted as being helpful in relieving or preventing motion sickness. In most cases, the proof supporting these products is not very good:-
Oral use of ginger or peppermint can sooth the stomach. Ginger, in pills or powder, is available in many herb or health food stores. Eating peppermint is also thought to be generally calming.
Reliefband.com (https://www.reliefband.com/) provides a transcutaneous electrical stimulation at the wrist which reduces motion sickness.
Persistent Sea Sickness – Mal De Debarquement (MDD) Syndrome
This is a prolonged rocking sensation – for a month or longer – that begins immediately following a lengthy exposure after exposure to passive motion, in most cases it is sea travel.
About 80% of MDD sufferers are women, and most of them are middle-aged.
MDD patients are often troubled by migraine.
The symptoms of MDD usually improve with re-exposure to motion.
Treatment of MDD with the common vestibular suppressants is nearly always ineffective. Benzodiazepines (Diazepam 1-2 mg o.d. for 1-2 weeks) can be helpful, but their usefulness is limited by the potential for addiction.