Swaying

Swaying is a complex of symptoms, usually involving nausea, often accompanied by vague abdominal discomfort, vomiting, dizziness, and related symptoms; cause - repeated angular and linear acceleration and deceleration. Behavioral change and drug therapy can help prevent or reduce symptomatology.

Individual susceptibility to motion sickness is very variable, but more typical for women. The frequency varies from <1% in airplanes to almost 100% on ships in sea waves and in cosmic weightlessness.

The main reason for motion sickness is excessive stimulation of the vestibular apparatus by movement. Afferent conductive pathways from the labyrinth to the vomiting center in the medulla oblongata were not identified, but motion sickness occurs only when the cranial VII and cerebellar vestibular tracts are intact. Movement during any form of transportation, including a ship, car, train, airplane, spaceship, attraction or play in the playground, can cause excessive vestibular stimulation. Swaying can also develop when, for various reasons, the vestibular, visual and proprioceptive pathways are at variance; When the nature of the movement differs from the previously tested one or when the movement is expected, but does not occur (for example, when you see movement on a TV screen or in a movie). Visual stimuli (eg moving horizon), poor ventilation (with vapors, smoke or carbon monoxide) and emotional factors (eg fear, anxiety) can act simultaneously with the movement, provoking an attack of the disease.

With the space adaptation syndrome (motion sickness during space flight), weightlessness (zero gravity) serves as an etiological factor. This syndrome reduces the effectiveness of cosmonauts during the first few days of space flight, but then comes the adaptation.

Symptoms and diagnostics of motion sickness

Nausea and vague abdominal discomfort are characteristic. Vomiting is also possible. These symptoms can be preceded by yawning, hyperventilation, salivation, pallor, profuse cold sweat and drowsiness. Other symptoms include aerophagia, dizziness, headache, fatigue, general weakness and inability to concentrate. Pain, shortness of breath, visual and speech disorders are absent. With prolonged action of motion, adaptation is possible. However, the symptoms may recur when the movement increases or after a short respite.

Prolonged motion sickness with vomiting occasionally leads to dehydration with arterial hypotension, exhaustion and depression. Swaying can occur more severely in patients with concomitant pathology.

The diagnosis is based on clinical data and is usually obvious. In some cases, cerebrovascular events, such as a stroke or a dynamic disorder of the cerebral circulation, can mimic the attack of motion sickness.

Means for motion sickness and treatment of motion sickness

There are several ways, but their use is more effective for prevention than for treating already developed symptoms. People prone to motion sickness should take preventive measures before the onset of symptoms. Scopolamine is used in the form of a patch or tablets for oral administration. A plaster is a good choice for longer trips, since being pasted behind the ear at least 4 hours before the trip (optimally 8-12 hours), it is effective up to 72 hours; the adhesive releases about 1 mg of the drug. Scopolamine prescribe inside at 0.4-0.8 mg per hour before the trip and then every 8 hours as needed. Side effects, including drowsiness, decreased visual acuity, dry mouth and bradycardia, are less common with the use of a patch. Accidental contamination of the eyes with the remnants of the patch can cause a persistent pronounced dilatation of the pupil. To additional negative effects scopalaminaulits elderly include confusion, hallucinations and urinary retention. Scopolamine is contraindicated in people at risk of developing a closed-angle glaucoma. Scopolamine can be administered to children over 12 years of age in the same dosages as adults. Use in children <12 years is likely safe, but not recommended.

As an alternative to the previous method 1 hour before departure, susceptible people can be given non-prescription dimenhydrinate, diphenhydramine or meclosin 25-50 mg orally 4 times daily (dimenhydrinate for children 2-6 years at 12.5-25 mg every 6-8 h, maximum 75 mg per day, children 6-12 years, 25-50 mg every 6-8 hours, maximum 150 mg per day); Promethazine 25-50 mg orally 2 times a day (children <12 years, 0.5 mg / kg body weight 2 times a day); or cyclizin 50 mg orally 4 times a day (children 6-12 years, 25 mg 3 times a day) to minimize vagus-dependent symptoms of the gastrointestinal tract. However, all these drugs are representatives of anti-cholinergic drugs and can cause side effects, especially in the elderly.

When vomiting is prescribed antiemetics, rectally or parenterally for greater effectiveness. If vomiting is delayed, intravenous administration of solutions and electrolytes may be required to replenish and maintain a fluid balance in the body.

The effectiveness of some non-medicinal methods has not been proven, but they can be useful. These include the use of bracelets that perform acupressure or conduct electrical stimulation. Both species can be safely used by people of all ages. Ginger (1-2 g) can help prevent motion sickness.

Prevention of motion sickness

Susceptible people should minimize the impact, settling down where the movement is minimal (for example, in the middle of the vessel closer to the water level, at the wings in the plane). When traveling in a car, it's best to sit in front, as the most favorable places are the driver's and front passenger's seats. Regardless of the mode of transport, the position of the back to the movement should be avoided. The best position is on the back or reclining with the headrest. Adequate ventilation also helps to prevent symptoms of the disease. Readings should be avoided. The direction of the axis of view is 45 "above the horizon and, if possible, the concentration of the view on the fixed objects reduces the susceptibility to motion sickness." Alcohol and overeating before or during the journey increases the likelihood of seasickness. During long travel, frequent use of small amounts of liquid and light food are recommended Some people consider dry crackers and carbonated beverages, particularly light beer, to be more acceptable products, and it is better to abstain from food and drink for a short flight. Daptatsionnom syndrome in space should be avoided movements that provoke the appearance of symptoms.