Space motion sickness - Revision history

Rossdonaldson1: /* Differential Diagnosis */

2024-07-17T20:10:19Z

Differential Diagnosis

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 {{Space medicine}}
 {{Vertigo DDX}}
 ==Evaluation==

Rossdonaldson1: /* Differential Diagnosis */

2024-07-17T20:10:03Z

Differential Diagnosis

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	==Differential Diagnosis==		==Differential Diagnosis==
	{{Space medicine}}		{{Space medicine}}
			{{Vertigo DDX}}
	===Vertigo===		===Vertigo===
	*Vestibular/otologic		*Vestibular/otologic

Rossdonaldson1: /* Differential Diagnosis */

2024-07-17T20:06:02Z

Differential Diagnosis

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	==Differential Diagnosis==		==Differential Diagnosis==
			{{Space medicine}}

			===Vertigo===
	*Vestibular/otologic		*Vestibular/otologic
	**Benign paroxysmal positional vertigo (BPPV)		**Benign paroxysmal positional vertigo (BPPV)
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	***Thyroid Disease		***Thyroid Disease
	***Hypoglycemia		***Hypoglycemia


	==Evaluation==		==Evaluation==

Rossdonaldson1: Rossdonaldson1 moved page Space Motion Sickness to Space motion sickness

2024-07-17T19:55:48Z

Rossdonaldson1 moved page Space Motion Sickness to Space motion sickness

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(Sin diferencias)

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References

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	==References==		==References==
	<references/>		<references/>

			[[Category: Space Medicine]]

Rossdonaldson1: /* Management */

2024-07-17T19:52:53Z

Management

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	****Intramuscular 0.3-0.5mg Q6h		****Intramuscular 0.3-0.5mg Q6h
	****Oral 0.3-0.5mg		****Oral 0.3-0.5mg
			***[[Promethazine]] 25mg IM or per rectum (oral absorption is less predictable due to microgravity induced ileus)
	***Promethazine/ephedrine 25mg/25mg (Oral)		***Promethazine/ephedrine 25mg/25mg (Oral)
	****Most effective, higher side effects		****Most effective, higher side effects
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	***Diazepam 2.5-10 mg q6h PRN		***Diazepam 2.5-10 mg q6h PRN
	**IV Hydration		**IV Hydration


	==Disposition==		==Disposition==

SineMetu: Space Motion Sickness

2024-07-06T19:42:40Z

Space Motion Sickness

Página nueva

==Background==
*Space motion sickness (SMS) is a common condition experienced by 60-80% of astronauts during the first 2-3 days of spaceflight.
*Current research indicates that SMS is caused by conflicting sensory-motor control inputs from visual and tactile senses with inputs coming from the vestibular organs in the inner ear. <ref> Legner K. Humans in Space & Space Biology. Seminars of the United Nations Programme on Space Applications. 2003.</ref>
*SMS is a part of a larger constellation of symptoms known as Space Adaptation Syndrome (SAS) <ref>https://humanresearchroadmap.nasa.gov/Evidence/medicalConditions/Space_Motion_Sickness_(Space_Adaptation).pdf
</ref>
*Space motion sickness is very likely to occur during space flight and, without treatment, may lead to dehydration and decreased mission readiness.
*Similar symptoms to SMS can occur on return to earth gravity, pretreatment of these conditions is recommended.

==Clinical Features==
*Symptoms can vary between astronauts but typically include:
**Nausea
**Vomiting
**Loss of Appetite
**Dizziness
**Malaise
**Sweating
*Duration: Astronauts generally recover within 3-5 days

==Differential Diagnosis==
*Vestibular/otologic
**Benign paroxysmal positional vertigo (BPPV)
**Traumatic (following head injury)
**Infection
**Labyrinthitis
**Vestibular neuritis
**Ramsay Hunt syndrome
**Ménière's disease
**Ear foreign body
**Otic barotrauma
**Otosclerosis
*Neurologic
**Cerebellar stroke
**Vertebrobasilar insufficiency
**Lateral Wallenberg syndrome
**Anterior inferior cerebellar artery syndrome
**Neoplastic: cerebellopontine angle tumors
**Basal ganglion diseases
**Vertebral Artery Dissection
**Multiple sclerosis
**Infections: neurosyphilis, tuberculosis
**Epilepsy
**Migraine (basilar)
*Other
**Hematologic: anemia, polycythemia, hyperviscosity syndrome
**Toxic
***Alcohol
***Aminoglycosides
**Chronic renal failure
**Metabolic
***Thyroid Disease
***Hypoglycemia

==Evaluation==
*Comprehensive review of the astronaut's medical history, focusing on any previous experiences with motion sickness, vestibular function tests, and monitoring symptoms during the initial phase of spaceflight.
*Pre-flight training and simulations may help anticipate susceptibility.

===Workup===
*Tracking the onset, duration, and intensity of symptoms through self-reported logs and medical assessments.
*Physiological measurements
**Heart Rate
**Blood Pressure
**Blood Glucose
**Urine Output.

===Diagnosis===
*Diagnosis is primarily clinical, based on the presence of characteristic symptoms in the context of spaceflight.
*It is supported by the absence of alternative explanations for the symptoms.
*Early identification is crucial for effective management.
*Occurs during the first 3-5 days of spaceflight
*If symptoms start later or continue past 5 days look for alternative diagnosis.

==Management==
*Preventative Countermeasures
**Non-Pharmacological
***Tilt-transition devices <ref>Harm D. L., Parker D. E. (1994). Preflight adaptation training for spatial orientation and space motion sickness. J. Clin. Pharmacol. 34, 618–627. 10.1002/j.1552-4604.1994.tb02015.x </ref>
***Autogenic feedback training exercises <ref>Cowings P. S., Toscano W. B. (2000). Autogenic-feedback training exercise is superior to promethazine for control of motion sickness symptoms. J. Clin. Pharmacol. 40, 1154–1165. 10.1177/009127000004001010</ref>
***Virtual Reality training <ref> Stroud K. J., Harm D. L., Klaus D. M. (2005). Preflight virtual reality training as a countermeasure for space motion sickness and disorientation. Aviat. Space Environ. Med. 76, 352–356. </ref>
***Head or body rotation exercises <ref> Reschke M. F., Somers J. T., Ford G. (2006). Stroboscopic vision as a treatment for motion sickness: strobe lighting vs. shutter glasses. Aviat. Space Environ. Med. 77, 2–7. </ref>
***Galvanic Vestibular Stimulation <ref> Dilda V., Morris T. R., Yungher D. A., MacDougall H. G., Moore S. T. (2014). Central adaptation to repeated galvanic vestibular stimulation: implications for pre-flight astronaut training. PLoS ONE 9, e0112131. </ref>
**Pharmacological
***Scopolamine
****Fewest side effects, current recommendation
****Transdermal 1mg 12 hrs prior to flight, Q72h
****Intramuscular 0.3-0.5mg Q6h
****Oral 0.3-0.5mg
***Promethazine/ephedrine 25mg/25mg (Oral)
****Most effective, higher side effects
***Meclizine 25-50mg (Oral)
*Symptomatic Treatment
**Antihistamines: inhibit vestibular stimulation and vestibular-cerebellar pathways
***Meclizine (Antivert) 25mg PO QID
***Diphenhydramine (Benadryl) 25-50mg IM, IV, or PO q4hr
**Anticholinergics
***Scopolamine transdermal patch 0.5mg (behind ear) QID
**Antidopaminergics
***Metoclopramide 10-20 IV or PO TID
**Benzodiazepines
***Diazepam 2.5-10 mg q6h PRN
**IV Hydration

==Disposition==
*Most cases of space motion sickness resolve within a few days as the astronaut's body adapts to the space environment.
*Continuous monitoring and supportive care are provided to ensure the well-being of the affected individual.
*Astronauts typically recover fully and can continue with their mission activities without long-term effects.

==See Also==
*[[Space Medicine]]
*[[Space Adaptation Syndrome]]
*[[Vertigo]]
*[[Labrynthitis]]

==External Links==

==References==
<references/>