Management

In general the diagnosis of motion sickness is based on the reported symptoms in externally imposed motion. It is important to exclude peripheral or central vestibular disease since these can present with motion sickness (1).

Management options include:

• behavioural counter measures
  • e.g. - the traveler is advised to have a stable visual reference point (such as the horizon) to minimize visual-vestibular conflict during sea travel
  • controlled studies have shown that deliberate restriction of head movements is helpful, as is avoidance of tasks that enhance visual-vestibular conflict, such as reading when travelling
  • habituation programmes (repeated exposure to the nauseogenic stimulus) has been shown to be effective in prospective controlled studies
• antiemetics
  • drug treatment should be carried out carefully in patients who could benefit from using habituation methods since some (for example, hyoscine) may delay habituation either directly or indirectly via sedative effects
    
    
  • should be taken before exposure (rather than after the onset of symptoms)
    
    
  • drugs which are commonly used include:
    • antimuscarinics - hyoscine (scopolamine)
    • antihistamines - cinnarizine, meclozine, dimenhydrinate, cyclizine, chlorphenamine, and promethazine (Cetirizine and fexofenadine are ineffective)

Reference:

• (1) Murdin L, Golding J, Bronstein A. Managing motion sickness. BMJ. 2011;343:d7430