MdDS Symptom Severity Scale*

• 0      No sensation of abnormal motion.  
  
  

• 1-2     Sensation of rocking/bobbing/swaying is almost imperceptible. Most often noticed while walking but may also be recognized while sitting, standing or lying down. Can usually perform routine daily functions without the need for rest periods.
  
  

• 3-4     Rocking/bobbing/swaying sensation is almost constant but can function fairly well with occasional rest periods. The sensation of rocking/bobbing/swaying may include the perception of movement along either a horizontal or vertical axis. The floor seems to move when walking (as if walking on a suspension bridge, water bed, or trampoline). Altered balance. Cannot remain standing in a fixed position with eyes closed. 
  
  

• 5-6    Rocking/bobbing/swaying intensity is increased.  Accompanied by difficulty in concentration and/or mental confusion (impaired cognitive function).  Most routine tasks become difficult to accomplish.  Require periods of rest. May stumble when walking. 
  
  

• 7-8    Rocking/bobbing/swaying is more severe and noticeable while walking, standing, or sitting. Associated with considerable fatigue. Increased loss of concentration and/or mental confusion.  Balance is affected (bump into objects when walking; clumsy in handling objects; may drop things).
  
  9-10     Rocking/bobbing/swaying is extremely severe. Balance is very poor. Require support for walking and standing (have to hold onto walls). Significant mental confusion. Impaired ability to speak. Remain in bed most of the day. 

     *This symptom scale and the information provided herein are the summarized experiences of many patients with established MdDS.  Many patients often have greater awareness and more intense symptoms in the "initial" phase of this syndrome; subsequently, there is usually a transition into symptoms of "sustained" MdDS.  In addition, throughout the course of MdDS, symptom severity may vary during a given daily interval.  
    Temporary remissions may occur as brief intervals (e.g., for hours, days, or weeks). As a given course of MdDS progresses toward sustained remission, symptoms may become less severe and temporary remissions more frequent (although, sometimes, symptoms are alleviated overnight!).  In some patients, repeated bouts of MdDS occur over many years and are usually associated with another precipitating event, e.g., cruise, boat, or airplane travel.  
     Clinical studies have not been performed to validate this symptom scale.  Comprehensive clinical research studies are necessary in order to characterize the important features of disease presentation/progression, to provide an unambiguous diagnosis, and to establish optimum treatments or therapies.   

MdDS Symptoms are often increased:

• by stress

• with lack of sleep

• after working at a computer for extended intervals

• in bright lights

• in long hallways or aisles (such as in supermarkets)

• in stairwells

• with changes in barometric (weather) pressure

• in association with allergy symptoms

• at the end of the day

MdDS Symptoms are often alleviated:

• during travel. e.g., movement/motion in a car or airplane

• after establishing a vigorous exercise program

• after establishing a vestibular exercise program

MdDS Symptoms may be associated with:

• normal results in most clinical tests, e.g., MRI, ENG

• migraine, with or without headache

• feeling of pressure inside the head

• fullness or pressure in ears

• history of neck (cervical spine) pain