Optokinetic Head Roll Exercise to Treat Mal de Debarquement Syndrome (MdDS) Dizziness

There is a particular type of chronic dizziness called Mal de Debarquement Syndrome or MdDS which involves a constant slow swaying or rocking motion. This issue usually occurs after being on a boat, but can occur after a long train or car ride. In a minority of patients, this can spontaneously occur without any obvious triggering event. Fortunately, for the vast majority of patients, this chronic dizziness spontaneously resolves within 24 to 48 hours. However, for the unfortunate few, this dizziness may last weeks to months. There is a MDDS treatment exercise known as optokinetic head roll which can help resolve symptoms in up to 70% of patients within 5 days. The exercise targets something called the vestibulo-ocular reflex which is responsible for controlling eye movements in order to keep the vision stable during head motion. To start, download a metronome app & save links to optokinetic stripes on YouTube. • Metronome App: iPhone: https://apps.apple.com/us/app/smart-m... Droid: https://play.google.com/store/apps/de... • Optokinetic Stripes (color of stripes is just personal preference): YouTube Playlist (Black or Red Stripes):    • Optokinetic Stripes   Fushiki ETT (iPhone): https://apps.apple.com/nz/app/fushiki... Fushiki ETT (Droid): https://play.google.com/store/apps/de... Head Roll Exercise First, figure out the dominant direction of your rocking or swaying. See if you can identify what that direction is. If you can’t, just pick one side and go with that one. If after a few days, there is no improvement, then switch sides. Once you have picked a side, you will set the optokinetic stimulation stripes to go in the opposite direction. SO for example, if your sway is right side dominant, you will set the optokinetic stripes to move in the left direction. Hold the screen in front of the eyes such that it fills your visual field as much as possible. Next, set a metronome to 10 beats per minute (the videos of optokinetic stripes in the Youtube playlist above has a 10bpm sound included). Each beat is going to represent a full cycle of head movement. Without turning the head, you will first bring one ear down towards the shoulder. Then move the head back to neutral position. Then move the opposite ear towards the opposite shoulder, then back to neutral position. Try to make the head movement as one continuous smooth motion without stopping at any point. Each session should be performed for 3-5 minutes. Make sure to observe your physical reactions to the exercise and if you start to feel really ill, then stop and try again later. This exercise needs to be performed up to 8 times a day. If this exercise helps, you should start to feel improvement within 5 days. If you don't have an improvement in the first five days, then either this exercise will not work for you OR, you picked the wrong side to begin with in which case, you would repeat this entire exercise again, but in the opposite direction. If you need further help: https://customcarerehab.com Video created by Dr. Christopher Chang: https://www.FauquierENT.net Actor Credit: MJ Gordon ‪@marinjayden‬ Certified Yoga Alliance Instructor (RYP500, RPYT, Yin) Certified Fitness Instructor NCEP https://www.MJ-Gordon.com Still haven’t subscribed to Fauquier ENT on YouTube? ►► https://bit.ly/35SazwA Reference: Readaptation of the vestibulo-ocular reflex relieves the mal de debarquement syndrome. Neurol. 2014 Jul 15:5:124. https://pubmed.ncbi.nlm.nih.gov/25076... Sham-Controlled Study of Optokinetic Stimuli as Treatment for Mal de Debarquement Syndrome. Front Neurol. 2018 Oct 25:9:887. https://pubmed.ncbi.nlm.nih.gov/30410... Optokinetic motion sickness and pseudo-Coriolis effects induced by moving visual stimuli. Acta Otolaryngol 76(5): 339-348. 1973. https://pubmed.ncbi.nlm.nih.gov/4543918/ Prevention of overt motion sickness by incremental exposure to otherwise highly stressful coriolis accelerations. Aerospace Medicine 40(2): 142-148. 1969. https://pubmed.ncbi.nlm.nih.gov/5304382/