Department of Neurology, University of Minnesota, Minneapolis, MN, USA.
Psychology, School for Social Sciences, University of Westminster, London, UK.
J Vestib Res. 2021;31(5):327-344. doi: 10.3233/VES-200005.
We present diagnostic criteria for motion sickness, visually induced motion sickness (VIMS), motion sickness disorder (MSD), and VIMS disorder (VIMSD) to be included in the International Classification of Vestibular Disorders. Motion sickness and VIMS are normal physiological responses that can be elicited in almost all people, but susceptibility and severity can be high enough for the response to be considered a disorder in some cases. This report provides guidelines for evaluating signs and symptoms caused by physical motion or visual motion and for diagnosing an individual as having a response that is severe enough to constitute a disorder. The diagnostic criteria for motion sickness and VIMS include adverse reactions elicited during exposure to physical motion or visual motion leading to observable signs or symptoms of greater than minimal severity in the following domains: nausea and/or gastrointestinal disturbance, thermoregulatory disruption, alterations in arousal, dizziness and/or vertigo, headache and/or ocular strain. These signs and/or symptoms occur during the motion exposure, build as the exposure is prolonged, and eventually stop after the motion ends. Motion sickness disorder and VIMSD are diagnosed when recurrent episodes of motion sickness or VIMS are reliably triggered by the same or similar stimuli, severity does not significantly decrease after repeated exposure, and signs/symptoms lead to activity modification, avoidance behavior, or aversive emotional responses. Motion sickness/MSD and VIMS/VIMSD can occur separately or together. Severity of symptoms in reaction to physical motion or visual motion stimuli varies widely and can change within an individual due to aging, adaptation, and comorbid disorders. We discuss the main methods for measuring motion sickness symptoms, the situations conducive to motion sickness and VIMS, and the individual traits associated with increased susceptibility. These additional considerations will improve diagnosis by fostering accurate measurement and understanding of the situational and personal factors associated with MSD and VIMSD.
我们提出运动病、视觉诱导运动病（VIMS）、运动病障碍（MSD）和 VIMS 障碍（VIMSD）的诊断标准，以便纳入国际前庭障碍分类。运动病和 VIMS 是几乎所有人都会产生的正常生理反应，但在某些情况下，这种反应的易感性和严重程度可能足够高，以至于可以被认为是一种障碍。本报告提供了评估由身体运动或视觉运动引起的体征和症状以及诊断个体对足以构成障碍的反应的指导方针。运动病和 VIMS 的诊断标准包括在暴露于身体运动或视觉运动期间引起的不良反应，导致以下领域出现大于最小严重程度的可观察体征或症状：恶心和/或胃肠道紊乱、体温调节障碍、警觉度改变、头晕和/或眩晕、头痛和/或眼疲劳。这些体征和/或症状在运动暴露期间发生，随着暴露时间的延长而加剧，并在运动结束后最终停止。当运动病或 VIMS 的反复发作可被相同或类似的刺激可靠地触发、重复暴露后严重程度没有显著降低且体征/症状导致活动改变、回避行为或厌恶情绪反应时，诊断为运动病障碍或 VIMS 障碍。运动病/ MSD 和 VIMS/VIMSD 可以单独或同时发生。对身体运动或视觉运动刺激的反应的症状严重程度差异很大，并且由于年龄、适应和共病障碍，个体内部也会发生变化。我们讨论了测量运动病症状的主要方法、有利于运动病和 VIMS 的情况以及与易感性增加相关的个体特征。这些附加考虑因素将通过促进对 MSD 和 VIMSD 相关的情境和个人因素的准确测量和理解来改善诊断。
