Motion sickness is a common condition provoked by transportation or visual motion.
Characterised by nausea/vomiting, possibly accompanied by other symptoms such as dizziness or headache.
Controlled breathing is helpful during episodes.
Drug therapy includes antimuscarinics and antihistamines; however both may have significant adverse effects (notably drowsiness) and impede habituation (desensitisation).
Habituation and cognitive behavioural therapy may be useful for people who must undergo repeated provocative motion (e.g., for their occupations).
Motion sickness is characterised by stomach discomfort, nausea, and vomiting, accompanied by autonomic features such as pallor and sweating. Vomiting often provides temporary or permanent relief of these symptoms. Once a certain level of nausea is attained, vomiting is almost inevitable, even if the patient is removed from the motion environment.
The rate at which motion sickness develops varies with the intensity of motion. Nausea leading to vomiting may develop within a few minutes if the provocative motion stimulus is intense, whereas with moderately provocative motion the onset of nausea is delayed, and vomiting may not necessarily occur. If motion is sustained, as on a long sea voyage, most people develop some habituation and become less susceptible to motion sickness. Similarly, frequent short exposures to provocative motion lead to a protective habituation, although the ability to adapt is marked by substantial individual differences. With infrequent exposures the protective value of habituating experiences is lost, and the patient returns to baseline levels of susceptibility.
History and exam
Key diagnostic factors
- presence of risk factors
- epigastric discomfort
Other diagnostic factors
- cold sweating
- dry mouth
- yawning and sleepiness
- recent alcohol consumption
- unsteadiness and incoordination
- childhood age
- female sex
- Chinese ancestry
- family history of motion sickness
- history of migraine
- visual disorder
- alcohol use
- spatial disorientation and space-motion discomfort syndromes
- hormonal factors
- unpleasant odours/sight or smell of vomit
- conflicting sensory inputs (e.g., reading in car, tilting trains)
- psychological factors
- spatially loaded concurrent tasks
- neurological disorder
1st investigations to order
- clinical diagnosis
anticipated motion sickness
unanticipated motion sickness
Kenneth L. Koch, MD
Professor (Section Head Gastroenterology)
Wake Forest University
Health Sciences Center
KLK is an author of several references cited in this topic.
Dr Kenneth L. Koch would like to gratefully acknowledge Dr Michael Andrew Gresty, a previous contributor to this topic.
MAG is an author of several references cited in this topic.
Alan J. Benson, MB, ChB
Visiting Consultant to the Royal Air Force Centre for Aviation Medicine
Royal Air Force Henlow
AJB declares that he has no competing interests.
David Andrew Green, PhD
Lecturer in Human Cardiorespiratory and Aerospace Physiology
Division of Applied Biomedical Research
Department of Physiology
King's College London
DAG declares that he has no competing interests.
Michael von Brevern, MD, PhD
Department of Neurology
MVB declares that he has no competing interests.
Richard Lewis, MD
Otolaryngology and Neurology
Harvard Medical School
RL declares that he has no competing interests.
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