OBJECTIVE: Mal de debarquement syndrome (MdDS) is a balance disorder that 
typically starts after an extended exposure to passive motion, such as a boat or 
plane ride. Management is typically supportive (e.g. physical therapy), and 
symptoms that persist beyond 6 months have been described as unlikely to remit. 
This study was conducted to evaluate the response of patients with MdDS to 
management with migraine prophylaxis, including lifestyle changes and medical 
therapy.
STUDY DESIGN: Prospective review.
SETTING: Ambulatory setting at a tertiary care medical center.
METHODS: Clinical history, detailed questionnaires, and audiograms were used to 
diagnose patients with MdDS. Those patients with the diagnosis of the MdDS were 
placed on our institutional vestibular migraine management protocol. Treatment 
response was assessed with a quality-of-life (QOL) survey and visual analog 
scale.
RESULTS: Fifteen patients were diagnosed with MdDS, with a predominance of 
females (73%) and a mean age of 50 ± 13 years. Eleven patients (73%) responded 
well to management with a vestibular migraine protocol, which included lifestyle 
changes, as well as pharmacotherapy with verapamil, nortriptyline, topiramate, 
or a combination thereof. In comparison, a retrospective control group of 17 
patients demonstrated a lower rate of improvement when treated with vestibular 
rehabilitation and physical therapy.
CONCLUSION: Management of MdDS as vestibular migraine can improve patients' 
symptoms and increase the QOL. Nearly all the patients suffering from MdDS had a 
personal or family history of migraine headaches or had signs or symptoms 
suggestive of atypical migraine.
LEVEL OF EVIDENCE: 4 Laryngoscope, 127:1670-1675, 2017.