Motion Sickness Clinical Presentation

Updated: Nov 10, 2017
  • Author: Andrew Brainard, MD, MPH; Chief Editor: Selim R Benbadis, MD  more...
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Presentation

History

Exposure to real or perceived motion stimuli is required for the syndrome to be categorized as motion sickness. Motion stimuli may be categorized as a vertical linear acceleration (heave), horizontal translational motion in the lateral direction (sway), the fore-and-aft movement (surge), and/or an angular roll. The maximum symptoms frequently appear with motions with a frequency of 0.2 Hz (one cycle every 5 seconds). Long period motions like those experienced on a tilting train or large ship can be barely perceptible but still cause the syndrome. Virtual motions such as in a large video screen, microfiche reader, or other visual motions can precipitate motion sickness. [7]

Nausea is the hallmark symptom, although it is frequently preceded by several more subtle symptoms. These preceding symptoms are commonly described as generalized feeling of unwellness (malaise), drowsiness, fatigue, and irritability. They can be quite subtle and easily mistaken for emotional responses to the situation. An early sensation of “stomach awareness,” described as a fullness and discomfort in the epigastrium, is frequently the first reported symptom.

Nausea and vomiting in motion sickness and can be quite severe. A nonvertiginous dizziness sometimes associated and exaggerated sense of motion and difficulty ambulating.

Sopite syndrome, which is a constellation of symptoms that involves apathy, depression, disinclination for work, and decreased participation in group activities, can occur. [8] These and other neurophysiologic symptoms such as maliase, lethargy and agitation can persist for some time after the motion stimuli has ended.

The sensation of movement frequently persists after the cessation of motion. This syndrome, called mal de debarque, is considered worrisome if it lasts for longer than 3 days. [9]

Patients who have previously experience motion sickness are much more likely to experience it again. Along with pregnant women, patients with previous vestibular syndromes or illness, a propensity toward nausea, and patients with a migraine headache history have increased rates of motion sickness.

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Physical Examination

Besides vomiting, there are few detectable physical signs of motion sickness. Yawning and belching can be observed before conscious symptoms develop. Peri-oral and facial pallor can give patients a green appearance and can occur along with increased salivation, diaphoresis, and flushing. Increased postural sway, changes in electrogastrography, and decreases in skin resistance have all been correlated with the sensations of motion sickness.

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Causes

See Pathophysiology.

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