Motion Sickness

Motion Sickness is a topic covered in the 5-Minute Clinical Consult.

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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%.

Risk Factors

  • 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

General Prevention

See “General Measures.”

Pediatric Considerations
  • Rare in children <2 years of age
  • Incidence peaks between 3 and 12 years of age.
  • Antihistamines may cause excitation in children.
Geriatric Considerations
  • Age confers some resistance to motion sickness.
  • Elderly are at increased risk for anticholinergic side effects from treatment.
Pregnancy Considerations
  • 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

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