Motion sickness: Difference between revisions
No edit summary |
Elcatracho (talk | contribs) |
||
| (3 intermediate revisions by 2 users not shown) | |||
| Line 1: | Line 1: | ||
==Background== | ==Background== | ||
* Motion sickness occurs in the setting of passive motion or with a visual stimulus, which is perceived as actual movement (virtual reality). | *Motion sickness occurs in the setting of passive motion or with a visual stimulus, which is perceived as actual movement (virtual reality). | ||
* It is possible to induce motion sickness in nearly all adults with enough provocation. | *It is possible to induce motion sickness in nearly all adults with enough provocation. | ||
* Individuals are more susceptible to motion sickness, depending on the risk factors below. | *Individuals are more susceptible to motion sickness, depending on the risk factors below. | ||
==Risk Factors== | ===Risk Factors=== | ||
Patient Factors | *Patient Factors | ||
* Women | **Women | ||
* Ages 2-12 years old (peaks at 12 | **Ages 2-12 years old (peaks at 12 yo) | ||
* Hormonal: Pregnant, menstruating, oral contraceptives | **Hormonal: Pregnant, menstruating, oral contraceptives | ||
* Other sensory Illness: Altered visual or vestibular sensory cues (labrynthitis) | **Other sensory Illness: Altered visual or vestibular sensory cues (labrynthitis) | ||
* Migraine disorder | **Migraine disorder | ||
* Psychosocial | **Psychosocial | ||
Environmental Factors | *Environmental Factors | ||
* Type of motion: The greater the magnitude of low frequency horizontal or vertical motion the greater the motion sickness | **Type of motion: The greater the magnitude of low frequency horizontal or vertical motion the greater the motion sickness | ||
* Body position: Supine position alleviates motion sickness | **Body position: Supine position alleviates motion sickness | ||
==Clinical Features== | ==Clinical Features== | ||
* Dizziness | *[[Dizziness]] | ||
* Nausea | *[[Nausea]] | ||
* Increased salivation | *Increased salivation | ||
* General malaise | *General malaise | ||
* Diaphoresis | *Diaphoresis | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
* Benign positional | *[[Benign paroxysmal positional vertigo]] | ||
* Meniere Disease | *[[Meniere Disease]] | ||
* Vestibular | *[[Vestibular neuritis]] | ||
* | *[[Labyrinthitis]] | ||
* Cerebrovascular | *[[Stroke|Cerebrovascular event]] | ||
==Evaluation== | ==Evaluation== | ||
* Evaluation is clinical and based upon the patient's history. | *Evaluation is clinical and based upon the patient's history. | ||
* | *BMP to evaluate dehydration/electrolyte abnormalities if significant amount of vomiting | ||
* CT | *CT head (if concern for stroke/hemorrhage) | ||
==Management== | ==Management== | ||
* Antihistamines ( | *[[Antihistamines]] ([[Diphenhydramine]], chlorpheniramine, cyclizine, [[meclizine]]) | ||
* Anticholinergics ( | *[[Anticholinergics]] ([[Scopolamine]]) | ||
* Antidopaminergics (Promethazine, metoclopramide) | *Antidopaminergics ([[Promethazine]], [[metoclopramide]]) | ||
* Sympathomimetics (Ephedrine, amphetamines, caffeine) | *[[Sympathomimetics]] ([[Ephedrine]], [[amphetamines]], [[caffeine]]) | ||
* Benzodiazepines | *[[Benzodiazepines]] | ||
* | *[[Antiemetics]] ([[prochlorperazine]], [[ondansetron]]) | ||
* GABA agonists (baclofen, gabapentin) | * GABA agonists ([[baclofen]], [[gabapentin]]) | ||
==Disposition== | ==Disposition== | ||
* Discharge if motion sickness is the primary diagnosis | *Discharge if motion sickness is the primary diagnosis | ||
* Educate patient on motion sickness and their susceptibility based on their risk factors. Inform the patient on how to prevent motion sickness with body position and medications. Encourage patient to return to ED if symptoms worsen. | *Educate patient on motion sickness and their susceptibility based on their risk factors. Inform the patient on how to prevent motion sickness with body position and medications. Encourage patient to return to ED if symptoms worsen. | ||
==See Also== | ==See Also== | ||
*[[Vertigo]] | |||
==External Links== | ==External Links== | ||
Latest revision as of 22:32, 7 March 2021
Background
- Motion sickness occurs in the setting of passive motion or with a visual stimulus, which is perceived as actual movement (virtual reality).
- It is possible to induce motion sickness in nearly all adults with enough provocation.
- Individuals are more susceptible to motion sickness, depending on the risk factors below.
Risk Factors
- Patient Factors
- Women
- Ages 2-12 years old (peaks at 12 yo)
- Hormonal: Pregnant, menstruating, oral contraceptives
- Other sensory Illness: Altered visual or vestibular sensory cues (labrynthitis)
- Migraine disorder
- Psychosocial
- Environmental Factors
- Type of motion: The greater the magnitude of low frequency horizontal or vertical motion the greater the motion sickness
- Body position: Supine position alleviates motion sickness
Clinical Features
Differential Diagnosis
- Benign paroxysmal positional vertigo
- Meniere Disease
- Vestibular neuritis
- Labyrinthitis
- Cerebrovascular event
Evaluation
- Evaluation is clinical and based upon the patient's history.
- BMP to evaluate dehydration/electrolyte abnormalities if significant amount of vomiting
- CT head (if concern for stroke/hemorrhage)
Management
- Antihistamines (Diphenhydramine, chlorpheniramine, cyclizine, meclizine)
- Anticholinergics (Scopolamine)
- Antidopaminergics (Promethazine, metoclopramide)
- Sympathomimetics (Ephedrine, amphetamines, caffeine)
- Benzodiazepines
- Antiemetics (prochlorperazine, ondansetron)
- GABA agonists (baclofen, gabapentin)
Disposition
- Discharge if motion sickness is the primary diagnosis
- Educate patient on motion sickness and their susceptibility based on their risk factors. Inform the patient on how to prevent motion sickness with body position and medications. Encourage patient to return to ED if symptoms worsen.