Highlights & Basics
- Motion sickness is a common condition provoked by physical motion or visual motion.
- Characterized by nausea/vomiting, possibly accompanied by other symptoms such as dizziness, vertigo, or headache.
- Controlled breathing might be helpful to counteract symptoms of motion sickness.
- Drug therapy includes antimuscarinics and antihistamines; however both may have significant adverse effects (notably drowsiness) and impede habituation (desensitization).
- Habituation and cognitive behavioral therapy may be useful for people who must undergo repeated provocative motion (e.g., occupational exposures).
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Citations
Cha YH, Golding JF, Keshavarz B, et al. Motion sickness diagnostic criteria: consensus document of the Classification Committee of the Bárány Society. J Vestib Res. 2021;31(5):327-44.[Abstract][Full Text]
Centers for Disease Control and Prevention. CDC Yellow Book 2024: health information for international travel. Section 8: Travel by air, land & sea - motion sickness. May 2023 [internet publication]. [Full Text]
Spinks AB, Wasiak J. Scopolamine (hyoscine) for preventing and treating motion sickness. Cochrane Database Syst Rev. 2011;(6):CD002851.[Abstract][Full Text]
1. Cha YH, Golding JF, Keshavarz B, et al. Motion sickness diagnostic criteria: consensus document of the Classification Committee of the Bárány Society. J Vestib Res. 2021;31(5):327-44.[Abstract][Full Text]
2. Reason JT, Graybiel A. Changes in subjective estimates of well-being during the onset and remission of motion sickness symptomatology in the slow rotation room. Aerosp Med. 1970 Feb;41(2):166-71.
3. Hu S, Grant WF, Stern RM, et al. Motion sickness severity and physiological correlates during repeated exposures to a rotating optokinetic drum. Aviat Space Environ Med. 1991;62:308-314.[Abstract]
4. Guerraz M, Yardley L, Bertholon P, et al. Visual vertigo: symptom assessment, spatial orientation and postural control. Brain. 2001;124:1646-56.[Abstract][Full Text]
5. Stanney KM, Hale KS, Nahmens I, et al. What to expect from immersive virtual environment exposure: influences of gender, body mass index, and past experience. Hum Factors. 2003;45:504-520.[Abstract]
6. Kennedy RS, Fowlkes JE. Simulator sickness is polygenic and polysymptomatic: implications for research. Int J Aviat Psychol. 1992;2:23-38.
7. Kennedy R, Lane N, Lilienthal M, et al. Profile analysis of simulator sickness symptoms: application to virtual reality environments. Presence. 1992;1:295-301.
8. Golding JF, Stott JR. Effect of sickness severity on habituation to repeated motion challenges in aircrew referred for airsickness treatment. Aviat Space Environ Med. 1995;66:625-630.[Abstract]
9. Centers for Disease Control and Prevention. CDC Yellow Book 2024: health information for international travel. Section 8: Travel by air, land & sea - motion sickness. May 2023 [internet publication]. [Full Text]
10. Bronstein AM, Golding JF, Gresty MA. Visual vertigo, motion sickness, and disorientation in vehicles. Semin Neurol. 2020 Feb;40(1):116-29.[Abstract]
11. Keshavarz B, Golding JF. Motion sickness: current concepts and management. Curr Opin Neurol. 2022 Feb 1;35(1):107-12.[Abstract]
12. Turner M, Griffin MJ. Motion sickness in public road transport: passenger behavior and susceptibility. Ergonomics. 1999;42:444-461.[Abstract]
13. Flanagan MB, May JG, Dobie TG. Sex differences in tolerance to visually-induced motion sickness. Aviat Space Environ Med. 2005;76:642-46.[Abstract]
14. Kennedy RS, Lanham DS, Massey CJ, et al. Gender differences in simulator sickness incidence: implications for military virtual reality systems. Safe J. 1995;25:69-76.
15. Klosterhalfen S, Kellermann S, Pan F, et al. Effects of ethnicity and gender on motion sickness susceptibility. Aviat Space Environ Med. 2005;76:1051-1057.[Abstract]
16. Lawther A, Griffin MJ. A survey of the occurrence of motion sickness amongst passengers at sea. Aviat Space Environ Med. 1988;59:399-406.[Abstract]
17. Stern RM, Hu S, LeBlanc R, et al. Chinese hyper-susceptibility to vection-induced motion sickness. Aviat Space Environ Med. 1993;64: 827-830.[Abstract]
18. Zhang LL, Wang JQ, Qi RR, et al. Motion sickness: current knowledge and recent advance. CNS Neurosci Ther. 2016 Jan;22(1):15-24.[Abstract]
19. Golding JF, Mueller AG, Gresty MA. A motion sickness maximum around the 0.2 Hz frequency range of horizontal translational oscillation. Aviat Space Environ Med. 2001;72:188-192.[Abstract]
20. Lawther A, Griffin MJ. Prediction of the incidence of motion sickness from the magnitude, frequency, and duration of vertical oscillation. J Acoust Soc Am. 1987;82:957-966.[Abstract]
21. O'Hanlon JF, McCauley ME. Motion sickness incidence as a function of the frequency and acceleration of vertical sinusoidal motion. Aerosp Med. 1974;45:366-369.[Abstract]
22. Bijveld MM, Bronstein AM, Golding JF, et al. Nauseogenicity of off-vertical axis rotation vs. equivalent visual motion. Aviat Space Environ Med. 2008;79:661-665.[Abstract]
23. Drummond PD. Triggers of motion sickness in migraine sufferers. Headache. 2005;45:653-656.[Abstract]
24. Huang TC, Wang SJ, Kheradmand A. Vestibular migraine: an update on current understanding and future directions. Cephalalgia. 2020 Jan;40(1):107-21.[Abstract][Full Text]
25. Arshad Q, Moreno-Ajona D, Goadsby PJ, et al. What visuospatial perception has taught us about the pathophysiology of vestibular migraine. Curr Opin Neurol. 2024 Feb 1;37(1):32-9.[Abstract]
26. Stern RM, Koch KL, Stewart WR, et al. Spectral analysis of tachygastria recorded during motion sickness. Gastroenterol. 1987;92:92-97.[Abstract]
27. Neimer J, Eskiizmirliler S, Ventre-Dominey J, et al. Trains with a view to sickness. Curr Biol. 2001;11:R549-R550.[Abstract]
28. Williamson MJ, Thomas MJ, Stern RM. The contribution of expectations to motion sickness symptoms and gastric activity. Psychosom Res. 2004;56:721-6.[Abstract]
29. Houchens PW, Jones MB. Behavioral contagion in an experimental motion environment. Aviat Space Environ Med. 2003;74:649-653.[Abstract]
30. Zajonc TP, Roland PS. Vertigo and motion sickness. Part II: Pharmacologic treatment. Ear Nose Throat J. 2006;85:25-35.[Abstract]
31. Zajonc TP, Roland PS. Vertigo and motion sickness. Part I: vestibular anatomy and physiology. Ear Nose Throat J. 2005;84:581-584.[Abstract]
32. Ventre-Dominey J, Luyat M, Denise P, et al. Motion sickness induced by otolith stimulation is correlated with otolith-induced eye movements. Neuroscience. 2008;155:771-779.[Abstract]
33. Dai M, Kunin M, Raphan T, et al. The relation of motion sickness to the spatial-temporal properties of velocity storage. Exp Brain Res. 2003;151:173-189.[Abstract]
34. Cohen B, Dai M, Yakushin SB, et al. Baclofen, motion sickness susceptibility and the neural basis for velocity storage. Prog Brain Res. 2008;171:543-553.[Abstract]
35. Dai M, Sofroniou S, Kunin M, et al. Motion sickness induced by off-vertical axis rotation (OVAR). Exp Brain Res. 2010 Jul;204(2):207-22.[Abstract]
36. Stern RM, Leibowitz HW, Unblad I, et al. Tachygastria and motion sickness. Aviat Space Environ Med. 1985;56:1074-1077.[Abstract]
37. Drummond PD. Effect of tryptophan depletion on symptoms of motion sickness in migraineurs. Neurology. 2005;65:620-622.[Abstract]
38. von Reinhart J. Histamin-intoleranz: histamin und seekrankheit. Stuttgart: Thieme; 2004.
39. Lichtenberg BK, Young LR, Arrott AP. Human ocular counterrolling induced by varying linear accelerations. Exp Brain Res. 1982;48:127-136.[Abstract]
40. Merfeld DM, Park S, Gianna-Poulin C, et al. Vestibular perception and action employ qualitatively different mechanisms. II. VOR and perceptual responses during combined Tilt&Translation. J Neurophysiol. 2005;94:199-205.[Abstract][Full Text]
41. Merfeld DM, Park S, Gianna-Poulin C, et al. Vestibular perception and action employ qualitatively different mechanisms. I. Frequency response of VOR and perceptual responses during Translation and Tilt. J Neurophysiol. 2005;94:186-198.[Abstract][Full Text]
42. Wood SJ. Human otolith-ocular reflexes during off-vertical axis rotation: effect of frequency on tilt-translation ambiguity and motion sickness. Neurosci Lett. 2002;323:41-44.[Abstract]
43. Kheradmand A, Winnick A. Perception of upright: multisensory convergence and the role of temporo-parietal cortex. Front Neurol. 2017;8:552.[Abstract][Full Text]
44. Money KE, Cheung BS. Another function of the inner ear: facilitation of the emetic response to poisons. Aviat Space Environ Med. 1983;54:208-211.[Abstract]
45. Treisman M. Motion sickness: an evolutionary hypothesis. Science. 1977;197:493-495.[Abstract]
46. Yates BJ, Miller AD, Lucot JB. Physiological basis and pharmacology of motion sickness: an update. Brain Res Bull. 1998;47:395-406.[Abstract]
47. Reavley CM, Golding JF, Cherkas LF, et al. Genetic influences on motion sickness susceptibility in adult women: a classical twin study. Aviat Space Environ Med. 2006 Nov;77(11):1148-52.[Abstract][Full Text]
48. Drummond PD, Granston A. Facial pain increases nausea and headache during motion sickness in migraineurs. Brain. 2004;127:526-534.[Abstract]
49. Murdin L, Chamberlain F, Cheema S, et al. Motion sickness in migraine and vestibular disorders. J Neurol Neurosurg Psychiatry. 2015 May;86(5):585-7.[Full Text]
50. Pavlou M, Lingeswaran A, Davies RA, et al. Simulator based rehabilitation in refractory dizziness. J Neurol. 2004;251:983-95.[Abstract]
51. Takahashi M, Okada Y, Saito A, et al. Locomotion and motion sickness under horizontal and vertical reversal of vision. Acta Otolaryngol Suppl. 1991;481:319-21.
52. Lee SH, Kim M, Kim H, et al. Visual fatigue induced by watching virtual reality device and the effect of anisometropia. Ergonomics. 2021 Dec;64(12):1522-31.[Abstract]
53. Golding JF, Prosyanikova O, Flynn M, et al. The effects of smoking nicotine tobacco versus smoking deprivation on motion sickness. Aviat Space Environ Med. 2008;79:262.
54. Redfern MS, Furman JM, Jacob RG. Visually induced postural sway in anxiety disorders. J Anxiety Disord. 2007;21:704-716.[Abstract][Full Text]
55. Redfern MS, Yardley L, Bronstein AM. Visual influences on balance. J Anxiety Disord. 2001;15:81-94.[Abstract]
56. Romas RT, Jacob RG, Lilienfeld SO. Space and motion discomfort in Brazilian versus American patients with anxiety disorders. J Anxiety Disord. 1997;11:131-139.[Abstract]
57. Golding JF, Kadzere P, Gresty MA. Motion sickness susceptibility fluctuates through the menstrual cycle. Aviat Space Environ Med. 2005:76; 970-973.[Abstract]
58. Saman Y, Sharif M, Lee A, et al. Sex-disease dimorphism underpins enhanced motion sickness susceptibility in primary adrenal insufficiency: a cross-sectional observational study. Exp Brain Res. 2023 Apr;241(4):1199-206.[Abstract]
59. Stern RM, Hu S, Anderson RB, et al. The effects of fixation and restricted visual field on vection-induced motion sickness. Aviat Space Environ Med. 1990;61:712-715.[Abstract]
60. Streitberger K, Ezzo J, Schneider A. Acupuncture for nausea and vomiting: an update of clinical and experimental studies. Auton Neurosci. 2006;129:107-17.[Abstract]
61. Hu S, Stern RM, Koch KL. Electrical acustimulation relieves vection-induced motion sickness. Gastroenterology. 1992;102:1854-8.[Abstract]
62. Denise P, Vouriot A, Normand H, et al. Effect of temporal relationship between respiration and body motion on motion sickness. Auton Neurosci. 2009;151:142-6.[Abstract]
63. Golding JF. Predicting individual differences in motion sickness susceptibility by questionnaire. Pers Individ Dif. 2006;41:237-248.
64. Jokerst MD, Gatto M, Fazio R, et al. Slow deep breathing prevents the development of tachygastria and symptoms of motion sickness. Aviat Space Environ Med. 1999;70:1189-1192.[Abstract]
65. Yen Pik Sang F, Billar JP, Gresty MA, et al. Effect of a novel motion desensitization training regime and controlled breathing on habituation to motion sickness. Percept Mot Skills. 2005;101:244-256.[Abstract]
66. Yen Pik Sang FD, Billar JP, Golding JF, et al. Behavioral methods of alleviating motion sickness: effectiveness of controlled breathing and a music audiotape. J Travel Med. 2003;10:108-11.[Abstract][Full Text]
67. Yen Pik Sang FD, Golding JF, Gresty MA. Suppression of sickness by controlled breathing during mildly nauseogenic motion. Aviat Space Environ Med. 2003;74:998-1002.[Abstract]
68. Fiori F, David N, Aglioti SM. Processing of proprioceptive and vestibular body signals and self-transcendence in Ashtanga yoga practitioners. Front Hum Neurosci. 2014 Sep 18:8:734.[Abstract][Full Text]
69. Nigmatullina Y, Hellyer PJ, Nachev P, et al. The neuroanatomical correlates of training-related perceptuo-reflex uncoupling in dancers. Cereb Cortex. 2015 Feb;25(2):554-62.[Abstract][Full Text]
70. Wood CD, Graybiel A. Evaluation of 16 antimotion sickness drugs under controlled laboratory conditions. Aerospace Med. 1968;39:1341-1344.
71. Spinks AB, Wasiak J. Scopolamine (hyoscine) for preventing and treating motion sickness. Cochrane Database Syst Rev. 2011;(6):CD002851.[Abstract][Full Text]
72. Burton MJ, Roland PS, Rosenfeld RM. Extracts from The Cochrane Library: Scopolamine (hyoscine) for preventing and treating motion sickness. Otolaryngol Head Neck Surg. 2010;142:468-471.[Abstract]
73. Karrim N, Byrne R, Magula N, et al. Antihistamines for motion sickness. Cochrane Database Syst Rev. 2022 Oct 17;10(10):CD012715.[Abstract][Full Text]
74. Stewart JJ, Wood MJ, Parish RC, et al. Prokinetic effects of erythromycin after antimotion sickness drugs. J Clin Pharmacol. 2000;40:347-353.[Abstract]
75. Bar R, Gil A, Tal D. Safety of double-dose transdermal scopolamine. Pharmacotherapy. 2009;29:1082-1088.[Abstract]
76. Howland J, Rohsenow DJ, Minsky S, et al. The effects of transdermal scopolamine on simulated ship navigation and attention/reaction time. Int J Occup Environ Health. 2008;14:250-256.[Abstract]
77. Cowings PS, Toscano WB. Autogenic-feedback training exercise is superior to promethazine for control of motion sickness symptoms. J Clin Pharmacol. 2000;40:1154-65.[Abstract]
78. Golding JF, Stott JR. Objective and subjective time courses of recovery from motion sickness assessed by repeated motion challenges. J Vestib Res. 1997;7:421-428.[Abstract]
79. Stern RM, Hu SQ, Vasey MW, et al. Adaptation to vection-induced symptoms of motion sickness. Aviat Space Environ Med. 1989 Jun;60(6):566-72.[Abstract][Full Text]
80. Ressiot E, Dolz M, Bonne L, et al. Prospective study on the efficacy of optokinetic training in the treatment of seasickness. Eur Ann Otorhinolaryngol Head Neck Dis. 2013;130:263-268.[Abstract]
81. Stroud KJ, Harm DL, Klaus DM. Preflight virtual reality training as a countermeasure for space motion sickness and disorientation. Aviat Space Environ Med. 2005;76:352-356.[Abstract]
82. Dobie TG, May JG. Cognitive-behavioural management of motion sickness. Aviat Space Environ Med. 1994;65:C1-C2.[Abstract]
83. Toscano WB, Cowings PS. Reducing motion sickness: a comparison of autogenic-feedback training and an alternative cognitive task. Aviat Space Environ Med. 1982;53:449-453.[Abstract]
84. Javid FA, Naylor RJ. The effect of serotonin and serotonin receptor antagonists on motion sickness in Suncus murinus. Pharmacol Biochem Behav. 2002;73:979-989.[Abstract]
85. Marcus DA, Furman JM. Prevention of motion sickness with rizatriptan: a double-blind, placebo-controlled pilot study. Med Sci Monit. 2006;12:PI1-PI7.[Abstract]
86. Furman JM, Marcus DA, Balaban CD. Rizatriptan reduces vestibular-induced motion sickness in migraineurs. J Headache Pain. 2011 Feb;12(1):81-8.[Abstract][Full Text]
87. Klocker N, Hanschke W, Toussaint S, et al. Scopolamine nasal spray in motion sickness: a randomised, controlled, and crossover study for the comparison of two scopolamine nasal sprays with oral dimenhydrinate and placebo. Eur J Pharm Sci. 2001;13:227-232.[Abstract]
88. Ahmed S, Sileno AP, de Meireles JC, et al. Effects of pH and dose on nasal absorption of scopolamine hydrobromide in human subjects. Pharm Res. 2000;17:974-977.[Abstract]
89. Simmons RG, Phillips JB, Lojewski RA, et al. The efficacy of low-dose intranasal scopolamine for motion sickness. Aviat Space Environ Med. 2010;81:405-412.[Abstract]
90. Stankovic AS, Alvarenga DL, Coleman Daniels VR, et al. Intranasal scopolamine for motion sickness. Aerosp Med Hum Perform. 2019 Nov 1;90(11):917-24.[Abstract][Full Text]
91. Yang M, Li Z, Pan F, et al. Alpha tACS on parieto-occipital cortex mitigates motion sickness based on multiple physiological observation. IEEE Trans Neural Syst Rehabil Eng. 2024;32:2398-407.[Abstract][Full Text]
92. Li G, Zanto T. Reduced VR motion sickness by applying random-phase transcranial alternating current stimulation to the left parietal cortex. Brain Stimul. 2024 May-Jun;17(3):550-2.[Full Text]
93. Takeuchi N, Mori T, Suzukamo Y, et al. Modulation of excitability in the temporoparietal junction relieves virtual reality sickness. Cyberpsychol Behav Soc Netw. 2018 Jun;21(6):381-7.[Abstract]
94. Arshad Q, Cerchiai N, Goga U, et al. Electrocortical therapy for motion sickness. Neurology. 2015 Oct 6;85(14):1257-9.[Full Text]
95. Grunfeld E, Price C, Goadsby P, et al. Migraine, motion sickness and menstruation in mariners. Lancet. 1998;351:1106.[Abstract]
