Motion sickness: an overview

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Abstract

Background: Motion sickness is a common phenomenon that affects almost everybody at some point in their lifetime. Clinicians should be familiar with the proper management of this condition.

Objective: To provide an update on the current understanding of the pathophysiology and management of motion sickness.

Methods: A PubMed search was performed with Clinical Queries using the key term ‘motion sickness.’ The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews. The search was restricted to English literature. The information retrieved from the earlier search was used in the compilation of the present article.

Results: Motion sickness is typically triggered by low-frequency vertical, lateral, angular, rotary motion, or virtual stimulator motion, to which an individual has not adapted. Sine qua non for developing motion sickness is when the brain receives conflicting information from different sensors about real body movements or virtual environment. The principal sensors are the eyes, the vestibular apparatus, and proprioceptive receptors. The conflicting information is judged in relation to a pattern of expected associations formed under normal or experienced conditions stored in the brain. Motion sickness typically presents with malaise, anorexia, nausea, yawning, sighing, increased salivation, burping, headache, blurred vision, non-vertiginous dizziness, drowsiness, spatial disorientation, difficulty concentrating, and sometimes vomiting. Simple behavioral and environmental modifications can be effective in the prevention of motion sickness. Medications that are effective in the prophylaxis and/or treatment of motion sickness include anticholinergics, antihistamines, and sympathomimetics.

Conclusion: In most cases, motion sickness can be prevented by behavioral and environmental modifications (avoidance, habituation, and minimization of motion stimuli). Pharmacotherapy should be considered in the prevention and/ or treatment of more severe motion sickness and for patients who do not respond to conservative measures. Medications are most effective when combined with behavioral and environmental modifications. Drugs that are effective in the prophylaxis and/or treatment of motion sickness include anticholinergic agents and antihistamines.

Keywords: antihistamines, nausea, neural mismatch, scopolamine, sensory conflict, sympathomimetics, vomiting.

Citation: Leung AKC, Hon KL. Motion sickness: an overview. Drugs in Context 2019; 8: 2019-9-4. DOI: 10.7573/dic.2019-9-4

Contributions: Professor Alexander KC Leung is the principal author. Professor Kam Lun Hon is the co-author who contributed and helped with the drafting of this manuscript. Both named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Disclosure and potential conflicts of interest: Professor Alexander KC Leung and Professor Kam Lun Hon are associate editors of Drugs in Context and confirm that this article has no conflicts of interest otherwise. This manuscript was sent out for independent external peer review by the editor-in-chief. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at https://www.drugsincontext.com/wp-content/uploads/2019/11/dic.2019-9-4-COI.pdf

Acknowledgments: None.

Funding declaration: Professor Leung and Professor Hon disclose no relevant financial relationship.

Copyright: Copyright © 2019 Leung AKC, Hon KL. https://doi.org/10.7573/dic.2019-9-4. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0 which allows anyone to copy, distribute, and transmit the article provided it is properly attributed in the manner specified below. No commercial use without permission.

Correct attribution: Copyright © 2019 Leung AKC, Hon KL. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0.

Article URL: https://www.drugsincontext.com/motion-sickness:-an-overview/

Correspondence: Dr Alexander KC Leung, MBBS, FRCPC, FRCP (UK and Irel), FRCPCH, FAAP (ORCID 0000-0003-2254-6971), The University of Calgary, Alberta Children’s Hospital, #200, 233 – 16th Avenue NW, Calgary, Alberta, Canada T2M 0H5. aleung@ucalgary.ca

Provenance: invited; externally peer reviewed.

Submitted: 25 September 2019; Peer review comments to author: 6 November 2019; Revised manuscript received: 8 November 2019; Accepted: 11 November 2019; Publication date: 13 December 2019.

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