When the Ground Still Rocks: A Study of Disembarkment Syndrome in Maritime Workers

Abstract Introduction: Disembarkment Syndrome or Mal de debarquement syndrome (MdDS) is a clinical syndrome characterized by vertigo, which is non-spinning and present continuously or for most of the day. The onset of this vertigo occurs within 48 hours after the end of exposure to passive motion. Vertigo of MdDS temporarily reduces on exposure to passive motion, and it persists for more than 48 hours. The literature on this condition is relatively sparse. This study is aimed to assess the prevalence of MdDS among professional maritime workers, to assess their associated symptoms and the effect of MdDS on their quality of life (QoL). Methods: This study was a questionnaire based cross sectional survey among professional maritime workers in India. Participants were requested to respond to a set of comprehensive questions regarding demographic details, duration of sailing and symptomatology pertaining to MdDS. Diagnosis of MdDS was done by using diagnostic criteria given by Barany society. Data were compiled on an excel sheet and results were analyzed. Results: 322 maritime workers participated in the survey. Among 322 maritime workers, 107 had some form of vertigo following sailing and among them 42 maritime workers fulfilled the diagnostic criteria for MdDS as per Barany Society. The study has determined that the prevalence of MdDS among professional maritime workers in India is 13.98% of which 3.1% have “transient MdDS”, 10.25% have “persistent MdDS” and 2.48% have “MdDS in evolution”. Discussion: The main differential diagnoses for MdDS include vestibular migraine, motion sickness and persistent postural perceptual dizziness. The results of this study may aid in diagnosing this specific clinical condition, especially when faced with a diagnostic dilemma when all neurotological investigations are normal. This may help in counselling the maritime workers about the benign nature of the condition, reassurance and stress relief.