Desensitization Treatment of Motion Sickness

Patient, female, 24 years old. Complaint: Recurrent motion sickness for many years. Present history: For many years, the patient has experienced motion sickness when riding in a car, with varying degrees of symptoms, including dizziness, nausea, vomiting, sweating, pallor, rapid heartbeat, etc. She still felt tired and uncomfortable for a short time after riding in a car, and her appetite decreased, but after a certain period of recovery, the above symptoms disappeared completely. The patient often needed to take oral anti-motion sickness medication before each ride to control the symptoms of motion sickness. The patient had no significant headache symptoms and no hearing loss or tinnitus or ear fullness symptoms, and she was seen on June 9, 2017 at the outpatient clinic for the proposed desensitization treatment of motion sickness. Past history: no history of migraine, Meniere disease, benign paroxysmal positional vertigo, or other ear disorders. No family history of hereditary disease. Examination: General condition was good, blood pressure 110/70 mmHg. Otological examination: no abnormality of external auditory canal and tympanic membrane. Pure tone audiometry: normal hearing curve in both ears. Spontaneous nystagmus was negative. Vestibular function tests such as test, velocity step test, cervical and ocular vestibular-evoked myogenic potentials (cVEMP and oVEMP), video head impulse test (vHIT), subjective visual vertical (SVV) and static posturography were not significantly abnormal, and the responses were basically symmetrical on both sides. Motion sickness Graybiel score: 11 points. Diagnosis: Motion sickness. Treatment: The patient underwent a "stepwise exercise program for motion sickness." The exercises were carried out through the SRM-IV diagnosis & treatment system for vertigo, with one exercise session every 2 days, for a total of ten sessions. The specific exercise program was as follows: (1) Vertical semicircular canal function exercise: 120° rotation in the right posterior-left anterior semicircular canal plane, 3 times clockwise and 3 times counterclockwise; 120° rotation in the left posterior-right anterior semicircular canal plane, 3 times counterclockwise and 3 times clockwise. The above steps constituted one therapeutic maneuver, with an interval of 10 s between each step. A total of ten therapeutic maneuvers were performed, the first three maneuvers were slow operations, i.e., each maneuver took 4 s with an acceleration of 120°/s; the fourth to sixth maneuvers were medium operations, i.e., each maneuver took 3 s with an acceleration of 150°/s; the last four maneuvers were fast operations, i.e., each maneuver took 2 s with an acceleration of 180°/s. (2) Horizontal semicircular canal functional exercise: 180° rotation in the horizontal semicircular canal plane, alternating between counterclockwise and clockwise, for a total of 8 times. The above steps constituted one therapeutic maneuver, with an interval of 10 s between each step. A total of ten treatment maneuvers were performed, with the first three maneuvers being slow operations, i.e., 5 s/maneuver with an acceleration of 140°/s; the fourth to sixth maneuvers being medium operations, i.e., 3 s/maneuver with an acceleration of 160°/s; and the last four maneuvers being fast operations, i.e., 2 s/maneuver with an acceleration of 180°/s. Follow-up of patients after receiving the stepwise exercise for motion sickness. The results showed no significant difference in their vestibular function test results between pre- and post-exercise, and their motion sickness Graybiel score decreased to five points. The patient reported a slight reduction in discomfort during car rides after the fifth exercise session, a significant reduction in discomfort during car rides after the seventh exercise session, and almost no discomfort during car rides after the tenth exercise session.