Presentation
Motion sickness will present as the following signs and symtoms [4]:
Neurological
The affected person will complain of a feeling of unease, cold sweats and nausea. It may progress to dizziness and abrupt vomiting.
Entire Body System
- Fatigue
Dizziness, fatigue, and nausea are the most common symptoms of motion sickness. Sopite syndrome in which a person feels fatigue or tiredness is also associated with motion sickness. Nausea in Greek means seasickness. [definitions.net]
Symptoms generally consist of dizziness, fatigue, and nausea which may progress to vomiting. [web.archive.org]
Her symptoms escalated into extreme fatigue and the inability to stay awake. Nauseogenic symptoms improved, but soporific symptoms persisted for several hours after the motion stimulus (i.e. parabolic flight). [ncbi.nlm.nih.gov]
- Pain
Concerning PRs in general, the results may have implications for clinical as well as experimental research on other symptoms and disorders, such as pain or depression. [ncbi.nlm.nih.gov]
Completed NCT01733212 Phase 2, Phase 3 Ginger;Placebo Oral Tablet 23 Preoperative Dexamethasone Reduces Postoperative Pain, Nausea and Vomiting Following Mastectomy for Breast Cancer. [malacards.org]
According to a 2011 study published in The Journal of Headache and Pain, rizatriptan—the only migraine medication specifically shown to reduce motion sickness—lessened motion-sickness symptoms in 87 percent of patients with migraines. [realsimple.com]
- Pallor
Motion sickness can produce uncomfortable or unpleasant and sometimes incapacitating manifestations, but the most common include pallor, cold sweating (diaphoresis), anorexia, nausea, and vomiting. [medlink.com]
Abstract Visually induced motion sickness (VIMS) is a well-known sensation in virtual environments and simulators, typically characterized by a variety of symptoms such as pallor, sweating, dizziness, fatigue, and/or nausea. [ncbi.nlm.nih.gov]
Symptoms and indications: Queasiness, dizziness, fatigue, nausea, rapid breathing, and pallor (loss of colour) which may progress to vomiting. [jariboti.pk]
- Weakness
The overall relationship between anxiety and MSS scores was weak and only reached significance in healthy subjects. [ncbi.nlm.nih.gov]
Other more progressive symptoms of motion sickness Other symptoms that occur as the condition progresses include:- Feelings of weakness, fatigue and tiredness There may be mood swings, irritability lack of initiative and apathy Increased production of [news-medical.net]
Some of the most exciting advances in technology – virtual reality, wearable tech, superfast smartphones and 3D films and operating systems – may all be scuppered by a basic human weakness: motion sickness. [theguardian.com]
Aerophagia, dizziness, headache, fatigue, weakness, and inability to concentrate may also occur. Pain, shortness of breath, focal weakness or neurologic deficits, and visual and speech disturbances are absent. [merckmanuals.com]
- Malaise
Although nausea is the hallmark symptom, it is often preceded by stomach awareness, malaise, drowsiness, and irritability. [ncbi.nlm.nih.gov]
Pre-dive, six divers given transdermal scopolamine had no side effects, three had dry mouth, and two reported mild malaise or mental fuzziness. [archive.rubicon-foundation.org]
Motion sickness is a syndrome of nausea and vomiting, pallor, sweating, headache, dizziness, malaise, increased salivation, apathy, drowsiness, belching, hyperventilation, and stomach awareness. [bmj.com]
Symptoms Serious symptoms include: nausea vomiting pallor sweating drooling short breath dizziness drowsiness Other common signs are: sweating a general feeling of discomfort not feeling well (malaise) Mild symptoms are categorized as: headache mild unease [medicalnewstoday.com]
Respiratoric
- Cough
9.0 Generic name: diphenhydramine systemic Brand names: Benadryl, Banophen, Benadryl Allergy, Benadryl Children's Allergy, Dicopanol, Diphen, Allermax, Complete Allergy Relief, Diphedryl, Diphenhist, Dytuss, Q-Dryl, Quenalin, Siladryl Allergy, Silphen Cough [drugs.com]
emotional lability, somnolence, decreased libido, nervousness, night blindness, nystagmus, lacrimation disorder, tinnitus, taste perversion, chest pain, arrhythmia, peripheral vascular disorder, generalized oedema, haemoptysis, dyspnoea, increased cough [mymemory.translated.net]
Violent fits of coughing, hiccups, or asthma Anxiety Depression Overexertion (doing too much strenuous exercise can lead to vomiting shortly afterwards). [en.wikipedia.org]
* WHO defines (3) a suspected case as an illness that occurs in a person presenting after February 1, 2003, with a history of high fever (>100.4 oF [ >38 oC]); one or more respiratory symptoms, including cough, shortness of breath, and difficulty breathing [cdc.gov]
- Sneezing
It can also occur after any type of even minor head trauma, even as small as a violent sneeze or hitting your head on a cabinet, and with major head trauma or after a concussion. [entnet.org]
Phenergan is used to treat allergy symptoms such as itching, runny nose, sneezing, itchy or watery eyes, hives, and itchy skin rashes. Phenergan also prevents motion sickness, and treats nausea and vomiting or pain after surgery. [drugs.com]
Gastrointestinal
- Nausea
[…] sickness, unspecified (finding), Motion sickness NOS (finding), Motion sickness, Travel sickness, Riders' vertigo, disease (or disorder); travel sickness (any vehicle), nausea; roundabout, nausea; swing, roundabout; nausea, swing; nausea, Motion sickness [fpnotebook.com]
Circular vection induced a maximal nausea score of 2.5 +/- 0.2 and increased tachygastric activity and plasma vasopressin. Pretreatment with ginger (1,000 and 2,000 mg) reduced the nausea, tachygastria, and plasma vasopressin. [ncbi.nlm.nih.gov]
- Vomiting
It may include nausea, vomiting and dizziness. [fpnotebook.com]
Sweating bouts precede each bout of vomiting and severe nausea. [news-medical.net]
[…] in High-risk Patients for Postoperative Nausea and Vomiting Completed NCT01897337 Phase 4 Aprepitant;placebo 7 A Prospective Randomize Study: Prevention of Nausea and Vomiting in Plastic Surgery Completed NCT02382146 Phase 4 dexamethasone ondansetron [malacards.org]
The brain responds by inducing vomiting, to clear the supposed toxin. [en.wikipedia.org]
- Abdominal Pain
D ifficulties in food passing from the stomach to the small intestines which may cause abdominal pain, nausea or vomiting. Worsening of seizures. Tell your doctor about any worsening of seizures while using Transderm Scop ® patch. [transdermscop.com]
If patient experiences reduced abdominal pain after vomiting, then obstruction is a likely etiology. [en.wikipedia.org]
- Diarrhea
That usually makes the person feel slightly better, but the unfortunate ones who are most affected go on to repeated bouts of retching and diarrhea. There is no way to predict who is going to become motion sick. [leftseat.com]
Some of the common symptoms of a balance disorder include: Dizziness or vertigo Falling or a feeling as if you are going to fall Lightheadedness, fainting, or a floating sensation Blurred vision Confusion or disorientation Nausea and vomiting Diarrhea [onhealth.com]
Liver, Gall & Pancreas
- Jaundice
[…] using Phenergan and call your doctor at once if you have: severe drowsiness, weak or shallow breathing; a light-headed feeling, like you might pass out; confusion, agitation, hallucinations, nightmares; seizure (convulsions); fast or slow heartbeats; jaundice [drugs.com]
Cardiovascular
- Hypertension
[…] overstimulation of the labyrinthine canals of the ear)[citation needed] Ménière's disease Causes in the brain:[citation needed] Concussion Cerebral hemorrhage Migraine Brain tumors, which can cause the chemoreceptors to malfunction Benign intracranial hypertension [en.wikipedia.org]
Ann N Y Acad Sci 1164:29–36 PubMedCentral PubMed Google Scholar da Silva AA, do Carmo JM, Wang Z, Hall JE (2014) The brain melanocortin system, sympathetic control, and obesity hypertension. [doi.org]
- Heart Disease
glaucoma; enlarged prostate or problems with urination; stomach ulcer or obstruction; heart disease or high blood pressure; liver disease; adrenal gland tumor (pheochromocytoma); low levels of calcium in your blood (hypocalcemia); or if you have ever [drugs.com]
- Thrombosis
The Journal of Travel Medicine recently had an article dedicated to the benefits of in-flight exercise and the incidence of Deep Vein Thrombosis (DVT), which is the development of blood clots in the legs on long flights. [intltravelnews.com]
Eyes
- Blurred Vision
Need to know: Common side effects include dry mouth, drowsiness and blurred vision, so don’t drink alcohol or drive while wearing a patch. [besthealthmag.ca]
These problems include visual fatigue, eye strain, headaches, dizziness, blurred vision or collectively may be termed as visually induced motion sickness (VIMS). [ncbi.nlm.nih.gov]
Adverse events: blurred vision [doi.org]
Skin
- Sweating
Motion sickness can start suddenly, with a queasy feeling and cold sweats. It can then lead to dizziness and nausea and vomiting. Your brain senses movement by getting signals from your inner ears, eyes, muscles and joints. [fpnotebook.com]
Cold sweats As the condition progresses the symptoms worse. This leads to a cold sweat. Patient is usually covered with a thin layer of sweat all over his or her body. Sweating bouts precede each bout of vomiting and severe nausea. [news-medical.net]
KEYWORDS: Cross-coupling; Motion sickness; Skin conductance level; Sweating response; Vestibulo-sympathetic reflex [ncbi.nlm.nih.gov]
- Ulcer
Torres-Damas et al. (1) reported a case of a 78-year-old male patient with type 2 diabetes and ketoacidosis who presented with a swelling of the right side of his face, right facial paralysis, ptosis and a necrotic ulcer on the right palate due to the [hrcak.srce.hr]
[…] asthma, chronic obstructive pulmonary disease (COPD), sleep apnea, or other breathing disorder; a sulfite allergy; a history of seizures; a weak immune system (bone marrow depression); glaucoma; enlarged prostate or problems with urination; stomach ulcer [drugs.com]
Ask your doctor for advice before taking motion sickness medications, especially if you're feeling constipated, are pregnant, have a history of heart rhythm problems, or have a stomach ulcer, narrow angle glaucoma, or an enlarged prostate. [chealth.canoe.com]
[…] libido, nervousness, night blindness, nystagmus, lacrimation disorder, tinnitus, taste perversion, chest pain, arrhythmia, peripheral vascular disorder, generalized oedema, haemoptysis, dyspnoea, increased cough, sinusitis, pharyngitis, dysphagia, mouth ulceration [mymemory.translated.net]
- Blister
These are at least four times cheaper, plus they aren't in an irritating blister pack. These are great for non motion provoked nausea too. This medicine works better than any other brand! It is worth every penny and it is over the counter!!! [walmart.com]
This led James to propose that irritating or blistering the skin behind the ears would be a counterirritant that might keep the vestibular sense from being overexcited and which he tried his next sea voyage. [apa.org]
- Pruritus
45 Influence of Gravity on the Perception of Egocentric Distance (Blindpulling) Unknown status NCT02508545 46 Effects of Inverted Vision on Pointing and Grasping in Parabolic Flight Unknown status NCT02885844 47 Risk Factors for Nausea, Vomiting and Pruritus [malacards.org]
Neurologic
- Dizziness
It may include nausea, vomiting and dizziness. [fpnotebook.com]
RESULTS: The prophylactic medications significantly improved the headache profiles, all three parameters of dizziness (dizziness handicap inventory, University of California Los Angeles dizziness questionnaire, and vertigo symptom scale), and severity [ncbi.nlm.nih.gov]
It can then lead to dizziness and nausea and vomiting.your brain senses movement by getting signals from your inner ears, eyes, muscles and joints. When it gets signals that do not match, you can get motion sickness. [icd9data.com]
- Headache
The better technology gets, the more likely it is to give you a headache or make you throw up. [qz.com]
[…] of motion sickness (p CONCLUSION: The prophylactic medication for migraine also improves associated dizziness and motion sickness as well as the headaches. [ncbi.nlm.nih.gov]
There may be headaches. [news-medical.net]
- Confusion
(Other explanations exist—such as, that some of us are just worse at adapting to confusing sensory cues .) [qz.com]
If the sensations received by the brain happen to be contradictory, the brain becomes confused and motion sickness occurs. [symptoma.com]
Tell your doctor if you have any of these symptoms: confusion; agitation; rambling speech; hallucinations (seeing or hearing things that are not there); paranoid behaviors and delusions (false belief in something). [transdermscop.com]
Your inner ear balance mechanisms also feel different signals to those that your eyes are seeing which then sends your brain mixed, confusing messages. This confusion between messages then causes the symptom of motion sickness. [patient.info]
- Vertigo
In both cases, the sequelae may be vertigo, incoordination, imbalance, and unpleasant autonomic responses. Common environmental motion conditions include visual vertigo, motion sickness, and motorists' disorientation. [ncbi.nlm.nih.gov]
[…] body motion while traveling (symptom), travel sickness, Travel sickness NOS, Motion Sickness [Disease/Finding], Travel sickness (disorder), Travel sickness, unspecified (finding), Motion sickness NOS (finding), Motion sickness, Travel sickness, Riders' vertigo [fpnotebook.com]
- Irritability
The subject reported drowsiness and she noted mood changes such as irritation and annoyance. Furthermore, she was not able to perform her assigned task. Her symptoms escalated into extreme fatigue and the inability to stay awake. [ncbi.nlm.nih.gov]
These are at least four times cheaper, plus they aren't in an irritating blister pack. These are great for non motion provoked nausea too. This medicine works better than any other brand! It is worth every penny and it is over the counter!!! [walmart.com]
Other more progressive symptoms of motion sickness Other symptoms that occur as the condition progresses include:- Feelings of weakness, fatigue and tiredness There may be mood swings, irritability lack of initiative and apathy Increased production of [news-medical.net]
Workup
Motion sickness generally does not require an intensive work up. A detailed history will reveal travelling or the use of a stimulant [10].
To rule out any brain disease, a sensory, motor and cerebellar examination may be performed [7].
A blood test may be conducted to rule out any poisons or toxins.
Treatment
Treatment of motion sickness may be divided into three types:
Activity Change
Visually Induced Motion Sickness (VIMS) may be relieved by withdrawing the stimulant causing the sickness such as a video, computer game or simulator, etc [2]. Motion sickness due to motion felt but not visually seen may be relieved by fixing the gaze on a moving object, bringing the two opposing signals in sync with each other [9].
Medication
Some drugs such as Scopolamine, administered via transdermal patches, may be used. Other drugs like Dimenhydrinate and Meclizine may also be effective.
A common method of preventing and treating motion sickness, particularly used by people travelling long distances, is the use of an elastic band fitted with a small hard object. This band is worn on both arms with the hard object facing inwards [8]. This puts pressure on a fixed point and based on the principles of acupressure, acts on relieving motion sickness. An eyewear device may be used to block out external movements during road travel [5]. A highly computerised digital device may be worn during travels that creates fixed reference points for the eyes with relation to the user's position.
Prognosis
Motion sickness is not actually a disease, but rather it is a condition. This condition may begin from just a feeling of unease and cold sweats to nausea and dizziness to finally vomiting.
Vomiting may occur just once, or there may be several episodes till the cause is removed [6].
For example, if a person is reading a book (fixed visual stimuli) while travelling by car (motion picked by vestibular system) the brain will receive contradictory inputs. This will confuse the brain about whether the body is actually moving or not. As a result, the vomiting centres of the brain will become active and the person will develop nausea, dizziness and finally vomiting.
This may be resolved by simple measures such as looking out the window (the passing view will be in sync with the input of the vestibular system) and the brain will not be confused any more, so no motion sickness will occur.
Etiology
The Area Postrema
The area postrema is a region of the brain that functions to detect toxins and discordance between visual and balance stimuli. If any toxic or poisonous substance is detected in the blood, the area postrema immediately induces vomiting, which in this case is a physiological defence mechanism that acts to remove the offensive substance from the body.
The theory about how motion sickness occurs is: In the case of mixed sensations received by the brain, as occurring in motion sickness, such as motion that is only felt by the vestibular system present in the inner ear and not seen by the eyes, or the motion that is visually perceived but not detected by the vestibular system, a discordance occurs.
Contradictory sensations confuse the brain. In this case, the brain comes to the conclusion that one of the sensory systems is not functioning properly and this impaired functioning is due to toxins. As a result, the area postrema induces vomiting, again as a protective mechanism, but this time against the brain's 'assumed' presence of toxins.
Another theory regarding how motion sickness occurs is the Nystagmus Hypothesis.
Nystagmus Hypothesis
This theory has three main aspects. The first aspect highlights the close linkage between the oculomotor and vestibular systems. Stimuli perceived by the inner ear's otolith organs and the semi circular canals relay commands to the eyes' ocular muscles causing their movement. This involuntary movement indicates the close relation between the vestibular system and the oculomotor system.
The second aspect of the Nystagmus Hypothesis is regarding the Sherrington's Law. This law deals with the reciprocal inhibition that occurs every time during motion between muscle pairs of agonist/antagonist muscles. In the case of the Nystagmus Hypothesis, this law is taken into consideration with regards to extraocular muscles.
The third and last aspect is about Vagal stimulation. Note the sequence followed by the first two aspects showing first vestibular sensations and stimuli, then the involvement of ocular muscles. Next in sequence should be the contraction and stretching of the ocular muscles leading to vagal stimulation.
Thus, this hypothesis proposes that the stimulation of the vagus nerve is the causative agent of motion sickness.
Summing up, whatever the exact cause of motion sickness may be, one thing is crystal clear; kinetosis occurs due to a discordance between the sensations perceived by the visual system and those perceived by the inner ear's vestibular system.
Epidemiology
Race
There is no known evidence of a predisposition of motion sickness in any race [3].
Age
Children are generally more susceptible to motion sickness, however, it may occur in people of all ages.
Sex
Women are generally more sensitive and thus may be slightly more susceptible to motion sickness than men. Studies show that pregnant women are at a higher risk of suffering from motion sickness.
Pathophysiology
Motion sickness, as explained above, is due to a mismatch in the input received from various sensory systems [1]. On the basis of the type of sensory system in effect, motion sickness can be classified into three broad categories:
- Motion detected by the Visual System (VIMS)
- Motion detected by the Vestibular System
- Motion detected by both systems but does not correspond
Visually Induced Motion Sickness (VIMS)
As the name indicates, this is the type where the eyes see movement but the inner ear does not feel it at all, or picks up very little of it.
- Videos
Watching videos showing increased level of movements, particularly if the audience is highly sensitive, may lead to motion sickness. In such cases, the person watching the video is usually seated and thus not moving, so the vestibular system does not pick up any motion, but the eyes detect motion so a discordance occurs.
- Stimulator Sickness
This results due to movement detected by the visual system by a stimulant like computer or video games or simulators. The rapidly moving pictures and figures and changing colours on the screen may result in motion sickness.
Motion Detected by Vestibular System
This type of motion sickness occurs when movement is detected by the vestibular system only, i.e movement is felt, but not seen by the eyes. It is the most common type of kinetosis. It can be subdivided on the basis of type and medium of movement.
- Car Sickness
This is an extremely common manifestation occurring during road travel. In this case, the vestibular system feels that that the body is moving but the interior of the vehicle, i.e the environment as seen by the person, is not moving. This causes a discordance between the visual input and the vestibular input, leading to motion sickness. So, a person when trying to read a book while riding a car feels nauseas and dizzy because the visual stimulus (book) is fixed while the vestibular system feels movement (of the car). This can be lessened by looking out the window to the things passing by.
This is also a very common form of motion sickness. Although essentially the same as car sickness, seasickness is brought upon by the rocking movement of the boat. The person feels to be in motion while the interior of the boat, or the deck, appears to be stationary.
- Air Sickness
This type occurs during flights and although, is also essentially based on the same principle as the first two types, it may be slightly more severe than the other two forms. This is because air turbulence may cause more sharply felt movements. The small windows, the view through which is often obscured by clouds, may prevent the person from fixing his gaze on the moving exterior, and so the person becomes unable to do anything to reverse the discordance and vomiting occurs.
- Spin Sickness
This usually occurs either in space crafts that are rapidly spinning to create an artificial gravity effect or in amusement park rides. In both cases, the spinning motion causes the fluid in the semicircular canals to spin as well, so when the spinning abruptly stops, the fluid still remains in spin motion, thus causing dizziness and vomiting.
Motion felt by both Visual and Vestibular Systems but does not correspond
In this category, motion sickness occurs when even though both sensory pathways, as well as other sensory pathways like proprioception, skin sensations, etc relay the occurrence of motion, but the type of degree of motion may not be equal, or in sync with each other.
Prevention
Motion sickness may be prevented by:
- Taking prophylactic or anti-emetic pills before long journeys.
- Looking out the window of a car or train during rides.
- Using devices like arm bands, head wear, eyewear, etc during sea or air travels.
- Engaging in distracting activities during journeys like listening to songs, going to sleep, etc.
Summary
Motion sickness, also known as kinetosis, is a condition in which there is a discordance in the sensory perception of movement in our body. As we know, our brain receives signals from various body parts in relation to movement and then puts them together to determine how exactly the body is moving and where. If the sensations received by the brain happen to be contradictory, the brain becomes confused and motion sickness occurs.
A feeling of unease followed by cold sweats, dizziness and nausea occurs and the person may vomit till the cause of the motion sickness is found and resolved.
Motion sickness can occur during car rides, airplane flights and most commonly, during travels by sea. Since the common factor in the above mentioned things is travelling, motion sickness is also commonly called travel sickness.
The rocking motion of a boat, the turbulence experienced during air travel and the speed bumps felt while travelling by car may all provoke the feeling of nausea and dizziness. It can also be felt during train journeys and even the rides in an amusement park.
Since the centre of balance and equilibrium is affected, motion sickness is a type of spatial disorientation which is quick to occur, but also resolves either spontaneously or if the factor that caused the sickness attack is withdrawn.
Patient Information
Definition
Motion sickness is a discordance between various sensory input of the body. It is usually the condition you feel when the motion felt by your inner ear is not in sync with what you see with your eyes.
Cause
The most common cause of motion sickness is travelling. It may be due to road, air or sea travel. In some rare cases, it may be not be due to travelling but by watching high resolution videos or computer games.
Signs and Symptoms
It presents with cold sweats, nausea, dizziness and vomiting.
Treatment
It can be be treated by a change in activity, taking appropriate medication and the use of certain devices.
Prevention
Motion sickness may be prevented by the use of electronic devices during travels, taking medication before long journeys and by a change in the activity.
References
- Golding JF. Motion sickness susceptibility. Auton Neurosci. Oct 30 2006;129(1-2):67-76
- Dobie TG, May JG. Cognitive-behavioral management of motion sickness. Aviat Space Environ Med. Oct 1994;65(10 Pt 2):C1-2
- 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
- Lawson BD, Mead AM. The sopite syndrome revisited: drowsiness and mood changes during real or apparent motion. Acta Astronaut. Aug-Sep 1998;43(3-6):181-92.
- Stewart JJ, Wood MJ, Wood CD, Mims ME. Effects of ginger on motion sickness susceptibility and gastric function. Pharmacology. 1991;42(2):111-20.
- Yen Pik Sang FD, Golding JF, Gresty MA. Suppression of sickness by controlled breathing during mildly nauseogenic motion. Aviat Space Environ Med. Sep 2003;74(9):998-1002.
- Spinks A, Wasiak J. Scopolamine (hyoscine) for preventing and treating motion sickness. Cochrane Database Syst Rev. 2011;(6):CD002851
- Cox DJ, Singh H, Cox DM. Effectiveness of acupressure and acustimulation in minimizing driving simulation adaptation syndrome. Mil Med. Dec 2011;176(12):1440-3
- Weichenthal L, Soliz T. The incidence and treatment of prehospital motion sickness. Prehosp Emerg Care. Oct-Dec 2003;7(4):474-6.
- Murdin L, Golding J, Bronstein A. Managing motion sickness. BMJ. 2011;343:d7430