Close
New

Medscape is available in 5 Language Editions – Choose your Edition here.

 

Motion Sickness Differential Diagnoses

  • Author: Andrew Brainard, MD, MPH; Chief Editor: Selim R Benbadis, MD  more...
 
Updated: Mar 23, 2016
 
 

Diagnostic Considerations

In an environment with a motion stimulus the diagniosis comes easily. In unusual cases, central causes of vertigo may need to be excluded. Patients can have cerebral vascular accidents and head trauma while traveling, and these diagnoses may need to be considered. Nausea in pregnancy may be falsely attributed to motion sickness. Atypical or vertiginous migraines can present in much the same way as some cases of motion sickness and other peripheral causes of dizziness may also need to be considered.

Other causes of discomfort should be assessed and should be empirically treated. Concurrent sources of discomfort, such as dehydration, sleep deprivation, hunger, hypoglycemia, hypothermia, intoxication, hangover, anxiety, depression, and heat and cold stressors, should be addressed.

  • CVA
  • Head Trauma
  • Pregnancy
  • Migraine
  • BPV
  • Dehydration
  • Sleep deprivation
  • Hypoglycemia
  • Intoxication
  • Anxiety
  • Depression
 
 
Contributor Information and Disclosures
Author

Andrew Brainard, MD, MPH Consultant Emergency Medical Physician, Director of Emergency Medical Education, Middlemore Hospital, New Zealand

Andrew Brainard, MD, MPH is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, Wilderness Medical Society

Disclosure: Nothing to disclose.

Coauthor(s)

Chip Gresham, MD, FACEM Emergency Medicine Physician and Medical Toxicologist, Department of Emergency Medicine, Clinical Director of Medication Safety, Middlemore Hospital; Senior Lecturer, Auckland University Medical School, New Zealand

Chip Gresham, MD, FACEM is a member of the following medical societies: American College of Emergency Physicians, American College of Medical Toxicology, Society for Academic Emergency Medicine, Emergency Medicine Residents' Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Selim R Benbadis, MD Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, Tampa General Hospital, University of South Florida College of Medicine

Selim R Benbadis, MD is a member of the following medical societies: American Academy of Neurology, American Medical Association, American Academy of Sleep Medicine, American Clinical Neurophysiology Society, American Epilepsy Society

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Cyberonics; Eisai; Lundbeck; Sunovion; UCB; Upsher-Smith<br/>Serve(d) as a speaker or a member of a speakers bureau for: Cyberonics; Eisai; Glaxo Smith Kline; Lundbeck; Sunovion; UCB<br/>Received research grant from: Cyberonics; Lundbeck; Sepracor; Sunovion; UCB; Upsher-Smith.

References
  1. Murdin L, Golding J, Bronstein A. Managing motion sickness. BMJ. 2011. 343:d7430. [Medline].

  2. Shupak A, Gordon CR. Motion sickness: advances in pathogenesis, prediction, prevention, and treatment. Aviat Space Environ Med. 2006 Dec. 77(12):1213-23. [Medline].

  3. Golding JF. Motion sickness susceptibility. Auton Neurosci. 2006 Oct 30. 129(1-2):67-76. [Medline].

  4. Nachum Z, Shupak A, Gordon CR. Transdermal scopolamine for prevention of motion sickness : clinical pharmacokinetics and therapeutic applications. Clin Pharmacokinet. 2006. 45(6):543-66. [Medline].

  5. Dobie TG, May JG. Cognitive-behavioral management of motion sickness. Aviat Space Environ Med. 1994 Oct. 65(10 Pt 2):C1-2. [Medline].

  6. Lawther A, Griffin MJ. A survey of the occurrence of motion sickness amongst passengers at sea. Aviat Space Environ Med. 1988 May. 59(5):399-406. [Medline].

  7. Haward BM, Lewis CH, Griffin MJ. Motions and crew responses on an offshore oil production and storage vessel. Appl Ergon. 2009 Sep. 40(5):904-14. [Medline].

  8. Chan G, Moochhala SM, Zhao B, Wl Y, Wong J. A comparison of motion sickness prevalence between seafarers and non-seafarers onboard naval platforms. Int Marit Health. 2006. 57(1-4):56-65. [Medline].

  9. Klosterhalfen S, Kellermann S, Pan F, Stockhorst U, Hall G, Enck P. Effects of ethnicity and gender on motion sickness susceptibility. Aviat Space Environ Med. 2005 Nov. 76(11):1051-7. [Medline].

  10. Stern RM, Hu S, LeBlanc R, Koch KL. Chinese hyper-susceptibility to vection-induced motion sickness. Aviat Space Environ Med. 1993 Sep. 64(9 Pt 1):827-30. [Medline].

  11. Dobie T, McBride D, Dobie T Jr, May J. The effects of age and sex on susceptibility to motion sickness. Aviat Space Environ Med. 2001 Jan. 72(1):13-20. [Medline].

  12. Golding JF, Gresty MA. Motion sickness. Curr Opin Neurol. 2005 Feb. 18(1):29-34. [Medline].

  13. Lawson BD, Mead AM. The sopite syndrome revisited: drowsiness and mood changes during real or apparent motion. Acta Astronaut. 1998 Aug-Sep. 43(3-6):181-92. [Medline].

  14. Cha YH. Mal de debarquement. Semin Neurol. 2009 Nov. 29(5):520-7. [Medline].

  15. Holtmann S, Clarke AH, Scherer H, Höhn M. The anti-motion sickness mechanism of ginger. A comparative study with placebo and dimenhydrinate. Acta Otolaryngol. 1989 Sep-Oct. 108(3-4):168-74. [Medline].

  16. Grontved A, Brask T, Kambskard J, Hentzer E. Ginger root against seasickness. A controlled trial on the open sea. Acta Otolaryngol. 1988 Jan-Feb. 105(1-2):45-9. [Medline].

  17. Stewart JJ, Wood MJ, Wood CD, Mims ME. Effects of ginger on motion sickness susceptibility and gastric function. Pharmacology. 1991. 42(2):111-20. [Medline].

  18. White B. Ginger: an overview. Am Fam Physician. 2007 Jun 1. 75(11):1689-91. [Medline].

  19. Ozgoli G, Goli M, Simbar M. Effects of ginger capsules on pregnancy, nausea, and vomiting. J Altern Complement Med. 2009 Mar. 15(3):243-6. [Medline].

  20. Yen Pik Sang FD, Golding JF, Gresty MA. Suppression of sickness by controlled breathing during mildly nauseogenic motion. Aviat Space Environ Med. 2003 Sep. 74(9):998-1002. [Medline].

  21. Dobie TG, May JG. Cognitive-behavioral management of motion sickness. Aviat Space Environ Med. 1994 Oct. 65(10 Pt 2):C1-2. [Medline].

  22. Miller KE, Muth ER. Efficacy of acupressure and acustimulation bands for the prevention of motion sickness. Aviat Space Environ Med. 2004 Mar. 75(3):227-34. [Medline].

  23. Wood CD, Manno JE, Wood MJ, Manno BR, Mims ME. Comparison of efficacy of ginger with various antimotion sickness drugs. Clin Res Pr Drug Regul Aff. 1988. 6(2):129-36. [Medline].

  24. Estrada A, LeDuc PA, Curry IP, Phelps SE, Fuller DR. Airsickness prevention in helicopter passengers. Aviat Space Environ Med. 2007 Apr. 78(4):408-13. [Medline].

  25. Spinks A, Wasiak J. Scopolamine (hyoscine) for preventing and treating motion sickness. Cochrane Database Syst Rev. 2011. (6):CD002851. [Medline].

  26. Nachum Z, Shupak A, Gordon CR. Transdermal scopolamine for prevention of motion sickness : clinical pharmacokinetics and therapeutic applications. Clin Pharmacokinet. 2006. 45(6):543-66. [Medline].

  27. Nachum Z, Shahal B, Shupak A, Spitzer O, Gonen A, Beiran I. Scopolamine bioavailability in combined oral and transdermal delivery. J Pharmacol Exp Ther. 2001 Jan. 296(1):121-3. [Medline].

  28. Simmons RG, Phillips JB, Lojewski RA, Wang Z, Boyd JL, Putcha L. The efficacy of low-dose intranasal scopolamine for motion sickness. Aviat Space Environ Med. 2010 Apr. 81(4):405-12. [Medline].

  29. Doweck I, Gordon CR, Spitzer O, Melamed Y, Shupak A. Effect of cinnarizine in the prevention of seasickness. Aviat Space Environ Med. 1994 Jul. 65(7):606-9. [Medline].

  30. Gordon CR, Gonen A, Nachum Z, Doweck I, Spitzer O, Shupak A. The effects of dimenhydrinate, cinnarizine and transdermal scopolamine on performance. J Psychopharmacol. 2001 Sep. 15(3):167-72. [Medline].

  31. Buckey JC Jr, Alvarenga DL, MacKenzie TA. Chlorpheniramine and ephedrine in combination for motion sickness. J Vestib Res. 2007. 17(5-6):301-11. [Medline].

  32. Cox DJ, Singh H, Cox DM. Effectiveness of acupressure and acustimulation in minimizing driving simulation adaptation syndrome. Mil Med. 2011 Dec. 176(12):1440-3. [Medline].

  33. Wood CD, Manno JE, Wood MJ, Manno BR, Mims ME. Comparison of efficacy of ginger with various antimotion sickness drugs. Clin Res Pr Drug Regul Aff. 1988. 6(2):129-36. [Medline].

  34. Lee A, Fan LT. Stimulation of the wrist acupuncture point P6 for preventing postoperative nausea and vomiting. Cochrane Database Syst Rev. 2009. (2):CD003281. [Medline].

  35. Hu S, Stritzel R, Chandler A, Stern RM. P6 acupressure reduces symptoms of vection-induced motion sickness. Aviat Space Environ Med. 1995 Jul. 66(7):631-4. [Medline].

  36. Bertolucci LE, DiDario B. Efficacy of a portable acustimulation device in controlling seasickness. Aviat Space Environ Med. 1995 Dec. 66(12):1155-8. [Medline].

  37. Gil A, Nachum Z, Tal D, Shupak A. A comparison of cinnarizine and transdermal scopolamine for the prevention of seasickness in naval crew: a double-blind, randomized, crossover study. Clin Neuropharmacol. 2012 Jan. 35(1):37-9. [Medline].

  38. Bar R, Gil A, Tal D. Safety of double-dose transdermal scopolamine. Pharmacotherapy. 2009 Sep. 29(9):1082-8. [Medline].

  39. Hershkovitz D, Asna N, Shupak A, Kaminski G, Bar R, Tal D. Ondansetron for the prevention of seasickness in susceptible sailors: an evaluation at sea. Aviat Space Environ Med. 2009 Jul. 80(7):643-6. [Medline].

  40. McClure JA, Lycett P, Baskerville JC. Diazepam as an anti-motion sickness drug. J Otolaryngol. 1982 Aug. 11(4):253-9. [Medline].

  41. Muth ER, Elkins AN. High dose ondansetron for reducing motion sickness in highly susceptible subjects. Aviat Space Environ Med. 2007 Jul. 78(7):686-92. [Medline].

  42. Weichenthal L, Soliz T. The incidence and treatment of prehospital motion sickness. Prehosp Emerg Care. 2003 Oct-Dec. 7(4):474-6. [Medline].

  43. Wright MS, Bose CL, Stiles AD. The incidence and effects of motion sickness among medical attendants during transport. J Emerg Med. 1995 Jan-Feb. 13(1):15-20. [Medline].

  44. Golding JF, Gresty MA. Pathophysiology and treatment of motion sickness. Curr Opin Neurol. 2015 Feb. 28 (1):83-8. [Medline].

  45. Brainard A, Gresham C. Prevention and treatment of motion sickness. Am Fam Physician. 2014 Jul 1. 90 (1):41-6. [Medline].

Previous
Next
 
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.