Managing motion sickness

#### Summary points Motion sickness is a syndrome of nausea and vomiting, pallor, sweating, headache, dizziness, malaise, increased salivation, apathy, drowsiness, belching, hyperventilation, and stomach awareness. Symptoms can be provoked by externally imposed motion, or implied self motion from a moving visual field, such as in a cinema. The condition has been recognised from the early days of sea travel and the word for sickness, “nausea,” derives from the Greek word νανς, meaning “ship.” Travel by car, train, or other transport is part of everyday life for most people, and motion sickness is a common problem. Estimating its prevalence is complex because reported symptoms depend on variables such as previous avoidance and exposure, as well as presumed inherent susceptibility. Some estimates are presented in table 1⇓. Motion sickness may have an important effect on occupational activity for some people, such as airline pilots, those in the armed forces, and emergency services staff. General practitioners may frequently encounter patients who report difficulties in work or daily life related to motion sickness, or those seeking advice about prevention before a forthcoming journey. We review the management …

[1]  Chlorpheniramine and ephedrine in combination for motion sickness. , 2008, Journal of vestibular research : equilibrium & orientation.

[2]  P. Monstad,et al.  Vestibular sensitivity in vestibular migraine: VEMPs and motion sickness susceptibility , 2011, Cephalalgia : an international journal of headache.

[3]  W. Bles,et al.  Motion sickness. , 2000, Current opinion in neurology.

[4]  Edi Albert.  Phenytoin for the prevention of motion sickness , 2003, The Medical journal of Australia.

[5]  J F Golding,et al.  Comparison of the effects of a selective muscarinic receptor antagonist and hyoscine (scopolamine) on motion sickness, skin conductance and heart rate. , 1997, British journal of clinical pharmacology.

[6]  C. Balaban,et al.  Vestibular autonomic regulation (including motion sickness and the mechanism of vomiting). , 1999, Current opinion in neurology.

[7]  M J Griffin,et al.  Airsickness and aircraft motion during short-haul flights. , 2000, Aviation, space, and environmental medicine.

[8]  J. Wasiak,et al.  Scopolamine (hyoscine) for preventing and treating motion sickness. , 2011, The Cochrane database of systematic reviews.

[9]  M. Griffin,et al.  A survey of the occurrence of motion sickness amongst passengers at sea. , 1988, Aviation, space, and environmental medicine.

[10]  M. Reschke,et al.  Motion sickness and development of synergy within the spatial orientation system. a hypothetical unifying concept , 1998, Brain Research Bulletin.

[11]  P. Enck,et al.  mu-Opiate receptor agonists -- a new pharmacological approach to prevent motion sickness? , 2006, British journal of clinical pharmacology.

[12]  I. Howard,et al.  Visually-induced sickness in normal and bilaterally labyrinthine-defective subjects. , 1991, Aviation, space, and environmental medicine.

[13]  D. Gollob.  Round the World , 1981, The Lancet.

[14]  J. Golding,et al.  Behavioral methods of alleviating motion sickness: effectiveness of controlled breathing and a music audiotape. , 2006, Journal of travel medicine.

[15]  John F. Golding,et al.  Effect of a Novel Motion Desensitization Training Regime and Controlled Breathing on Habituation to Motion Sickness , 2005, Perceptual and motor skills.

[16]  Jelte E Bos,et al.  Motion sickness symptoms in a ship motion simulator: effects of inside, outside, and no view. , 2005, Aviation, space, and environmental medicine.

[17]  Safety of Double-Dose Transdermal Scopolamine , 2010 .

[18]  C. Wood,et al.  Effects of ginger on motion sickness susceptibility and gastric function. , 1991, Pharmacology.

[19]  Y. Melamed,et al.  Effect of cinnarizine in the prevention of seasickness. , 1994, Aviation, space, and environmental medicine.

[20]  N Klöcker,et al.  Scopolamine nasal spray in motion sickness: a randomised, controlled, and crossover study for the comparison of two scopolamine nasal sprays with oral dimenhydrinate and placebo. , 2001, European journal of pharmaceutical sciences : official journal of the European Federation for Pharmaceutical Sciences.

[21]  J. Golding.  Motion sickness susceptibility , 2006, Autonomic Neuroscience.

[22]  M. Griffin,et al.  Motion sickness in public road transport: the relative importance of motion, vision and individual differences. , 1999, British journal of psychology.

[23]  M. Gresty,et al.  Relationship between motion sickness, migraine and menstruation in crew members of a “round the world” yacht race , 1998, Brain Research Bulletin.

[24]  C. Balaban,et al.  Rizatriptan reduces vestibular-induced motion sickness in migraineurs , 2010, The Journal of Headache and Pain.

[25]  T C Hain,et al.  Mal de debarquement. , 1999, Archives of otolaryngology--head & neck surgery.

[26]  Arthur Estrada,et al.  Airsickness prevention in helicopter passengers. , 2007, Aviation, space, and environmental medicine.

[27]  P. Goadsby,et al.  Neuroimaging of migraine. , 2006, Current pain and headache reports.

[28]  L. Yardley,et al.  Symptoms, anxiety and handicap in dizzy patients: development of the vertigo symptom scale. , 1992, Journal of psychosomatic research.

[29]  W. Hasler,et al.  Effects of ginger on motion sickness and gastric slow-wave dysrhythmias induced by circular vection. , 2003, American journal of physiology. Gastrointestinal and liver physiology.

[30]  J F Golding,et al.  The effects of motion direction, body axis, and posture on motion sickness induced by low frequency linear oscillation. , 1995, Aviation, space, and environmental medicine.

[31]  A. Bronstein,et al.  Vertigo as a migraine trigger , 2009, Neurology.

[32]  Renee A. Lojewski,et al.  The efficacy of low-dose intranasal scopolamine for motion sickness. , 2010, Aviation, space, and environmental medicine.

[33]  W. Ouwerkerk,et al.  Influence of transdermal scopolamine on motion sickness during 7 days' Exposure to heavy seas , 1985, Clinical pharmacology and therapeutics.

[34]  Peter A. Howarth,et al.  Characteristics of habituation to motion in a virtual environment , 2008, Displays.

[35]  E. Muth,et al.  High dose ondansetron for reducing motion sickness in highly susceptible subjects. , 2007, Aviation, space, and environmental medicine.

[36]  A. Bronstein,et al.  Effect of breathing supplemental oxygen on motion sickness in healthy adults. , 2003, Mayo Clinic proceedings.

[37]  P S Cowings,et al.  Promethazine as a motion sickness treatment: impact on human performance and mood states. , 2000, Aviation, space, and environmental medicine.