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- Motion sickness is a physiologic response in affected individuals to a situation in which sensory conflict about body motion exists among visual receptors, vestibular receptors, and body proprioceptors.
- Also can be induced when patterns of motion differ from those previously experienced
- System affected: nervous, gastrointestinal
- Synonym(s): car sickness; sea sickness; air sickness; space sickness; physiologic vertigo
Predominant sex: female > male
Estimation is complex; syndrome occurs in ~25% due to travel by air, ~29% by sea, and ~41% by road. Estimates for vomiting are 0.5% by air, 7% by sea, and 2% by road.
Etiology and Pathophysiology
- Precise etiology unknown; thought to be due to a mismatch of vestibular and visual sensations
- Rotary, vertical, and low-frequency motions produce more symptoms than linear, horizontal, and high-frequency motions.
- Nausea and vomiting occur as a result of increased levels of dopamine and acetylcholine, which stimulate chemoreceptor trigger zone and vomiting center in CNS.
Heritability estimates range from 55% to 75%.
- Motion (auto, plane, boat, amusement rides)
- Visual stimuli (e.g., moving horizon)
- Poor ventilation (fumes, smoke, carbon monoxide)
- Emotions (fear, anxiety)
- Zero gravity
- Pregnancy, menstruation, oral contraceptive use
- History of migraine headaches, especially vestibular migraine
See “General Measures.”
- Rare in children <2 years of age
- Incidence peaks between 3 and 12 years of age.
- Antihistamines may cause excitation in children.
- Age confers some resistance to motion sickness.
- Elderly are at increased risk for anticholinergic side effects from treatment.
- Pregnant patients are more likely to experience motion sickness.
- Treatment with medications is thought to be safe during morning sickness (e.g., meclizine, dimenhydrinate).
- Scopolamine, meclizine, diphenhydramine, and promethazine generally considered safe during breastfeeding
Commonly Associated Conditions
- Migraine headache
- Vestibular syndromes