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Motion sickness

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Vishnu Vardhan Serla M.B.B.S. [2]

Overview

Motion sickness or kinetosis is a condition in which a disagreement exists between visually perceived movement and the vestibular system‘s sense of movement. Depending on the cause it can also be referred to as seasickness, carsickness, simulation sickness, airsickness, or space sickness.

Epidemiology and Demographics

About 33% of people are susceptible to motion sickness even in mild circumstances such as being on a boat in calm water, although nearly 66% of people are susceptible in more severe conditions.[1] Approximately 50% of the astronauts in the U.S. space program have suffered from space sickness.[2]

History and Symptoms

Dizziness, fatigue, and nausea are the most common symptoms of motion sickness.[3] Sopite syndrome is also a side effect of motion sickness. In fact, nausea in Greek means seasickness (naus means ship).[4][5] If the motion causing nausea is not resolved, the sufferer will frequently vomit. Unlike ordinary sickness, vomiting in motion sickness tends not to relieve the nausea.

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Historical Perspective

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Classification

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Vishnu Vardhan Serla M.B.B.S. [2]

Classification

Airsickness

Airsickness is a sensation which is induced by air travel. It is a specific form of motion sickness, and is considered a normal response in healthy individuals. Airsickness occurs when the central nervous system receives conflicting messages from the body (including the inner ear, eyes and muscles) affecting balance and equilibrium.

Sea-sickness

Seasickness is a form of motion sickness characterized by a feeling of nausea and, in extreme cases, vertigo experienced after spending time on a craft on water. It is typically brought on by the rocking motion of the craft.

Simulation sickness

Simulation sickness, or simulator sickness, is a condition where a person exhibits symptoms similar to motion sickness caused by playing computer/simulation/video games.

The most common theory for the cause of simulation sickness is that the illusion of motion created by the virtual world, combined with the absence of motion detected by the inner ear, causes the area postrema in the brain to infer that one is hallucinating and further conclude that the hallucination is due to poison ingestion. The brain responds by inducing nausea and vomiting, to clear the supposed toxin.[1] According to this theory, simulation sickness is just another form of motion sickness.

The symptoms are often described as quite similar to that of motion sickness. Some can range from headache, drowsiness, nausea, dizziness, vomiting and sweating. A research done at the University of Minnesota had students play Halo for less than an hour, and found that up to 50 percent felt sick afterwards.[2]

In a study conducted by U.S. Army Research Institute for the Behavioral and Social Sciences in a report published May 1995 titled “Technical Report 1027 – Simulator Sickness in Virtual Environments”, out of 742 pilot exposures from 11 military flight simulators, “approximately half of the pilots (334) reported post-effects of some kind: 250 (34%) reported that symptoms dissipated in less than 1 hour, 44 (6%) reported that symptoms lasted longer than 4 hours, and 28 (4%) reported that symptoms lasted longer than 6 hours. There were also 4 (1%) reported cases of spontaneously occurring flashbacks”.[3][4]

Space sicknesss

Space sickness was effectively unknown during the earliest spaceflights, as these were undertaken in very cramped conditions; it seems to be aggravated by being able to freely move around, and so is more common in larger spacecraft. Around 60% of all Space Shuttle astronauts currently experience it on their first flight; the first case is now suspected to be Gherman Titov, in August, 1961 onboard Vostok 2, who reported dizziness and nausea. However, the first significant cases were in early Apollo flights; Frank Borman on Apollo 8 and Rusty Schweickart on Apollo 9. Both experienced identifiable and reasonably severe symptoms — in the latter case causing the mission plan to be modified.

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Pathophysiology

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Vishnu Vardhan Serla M.B.B.S. [2]

Pathophysiology

Motion sickness on the sea can result from being in the berth of a rolling boat without being able to see the horizon. Sudden jerky movements tend to be worse for provoking motion sickness than slower smooth ones, because they disrupt the fluid balance more. A “corkscrewing” boat will upset more people than one that is gliding smoothly across the oncoming waves. Cars driving rapidly around winding roads or up and down a series of hills will upset more people than cars that are moving over smooth, straight roads. Looking down into one’s lap to consult a map or attempting to read a book while a passenger in a car may also bring on motion sickness.

The most common hypothesis for the cause of motion sickness is that it evolved as a defense mechanism against neurotoxins.[1] The area postrema in the brain is responsible for inducing vomiting when poisons are detected, and for resolving conflicts between vision and balance. When feeling motion but not seeing it (for example, in a ship with no windows), the inner ear transmits to the brain that it senses motion, but the eyes tell the brain that everything is still. As a result of the disconcordance, the brain will come to the conclusion that one of them is hallucinating and further conclude that the hallucination is due to poison ingestion. The brain responds by inducing vomiting, to clear the supposed toxin.

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Causes


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];

Overview

Life Threatening Causes

Common Causes

Causes by Organ System

Cardiovascular No underlying causes
Chemical/Poisoning No underlying causes
Dental No underlying causes
Dermatologic No underlying causes
Drug Side Effect Pramipexole, Rifaximin
Ear Nose Throat No underlying causes
Endocrine No underlying causes
Environmental No underlying causes
Gastroenterologic No underlying causes
Genetic No underlying causes
Hematologic No underlying causes
Iatrogenic No underlying causes
Infectious Disease No underlying causes
Musculoskeletal/Orthopedic No underlying causes
Neurologic No underlying causes
Nutritional/Metabolic No underlying causes
Obstetric/Gynecologic No underlying causes
Oncologic No underlying causes
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal/Electrolyte No underlying causes
Rheumatology/Immunology/Allergy No underlying causes
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Miscellaneous No underlying causes

Causes in Alphabetical Order

Citing Sources

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Differentiating Motion Sickness from other Diseases

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Epidemiology and Demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Vishnu Vardhan Serla M.B.B.S. [2]

Overview

About 33% of people are susceptible to motion sickness even in mild circumstances such as being on a boat in calm water, although nearly 66% of people are susceptible in more severe conditions.[1] Approximately 50% of the astronauts in the U.S. space program have suffered from space sickness.[2]

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Risk Factors

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Natural History, Complications and Prognosis

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Diagnosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Other Imaging Findings | Other Diagnostic Studies

Treatment

Treatment

Medical Therapy | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case Studies

Case #1

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