Case ReportTranscranial Magnetic Stimulation as Treatment for Mal de Debarquement Syndrome: Case Report and Literature ReviewBuard, Isabelle PhD*; Lopez-Esquibel, Natalie BS†; Schoeneberger, Stefanie BS‡; Berliner, Jean M. PhD§; Kluger, Benzi M. MD*Author Information Departments of *Neurology §Physical Therapy, University of Colorado Denver, Aurora, Colorado †Department of Psychology and Neuroscience, Regis University, Denver, Colorado ‡Department of Clinical and Developmental Neuropsychology, University of Groningen, The Netherlands The authors declare no conflicts of interest. Correspondence: Isabelle Buard, PhD, University of Colorado, Denver, Anschutz Medical Campus, Department of Neurology, Fitzsimons Building, Mail Stop F548, 13001 E. 17th Place, Rm. R24-002, Aurora, Colorado 80045 (email: Isabelle.Buard@CUAnschutz.edu). Cognitive and Behavioral Neurology: June 2020 - Volume 33 - Issue 2 - p 145-153 doi: 10.1097/WNN.0000000000000224 Buy Metrics Abstract This manuscript presents the case of an adult, male patient with mal de debarquement syndrome (MdDS); results from his experimental treatment with repetitive transcranial magnetic stimulation (rTMS) are also provided. Additionally, we included a review of literature related to the neurophysiology of MdDS and its treatment with rTMS. A 41-year-old man had been experiencing symptoms of MdDS, which initially emerged following a car ride, for 11 to 12 years. Pharmacologic approaches had failed to provide symptom relief; thus, we investigated an intervention using low-frequency (1 Hz) rTMS unilaterally for 2 consecutive weeks. The outcome measures included a standardized, computerized dynamic posturography test to quantify the patient’s balance and identify abnormalities in his use of the sensory systems contributing to postural control, as well as the Hospital Anxiety and Depression Scale (HADS) to measure his anxiety and depression. An rTMS treatment log was created to document any adverse events. Following rTMS, the patient’s balance scores improved significantly; these improvements were mostly related to the patient’s increased reliance on the visual and vestibular systems. Our patient’s HADS Anxiety and Depression subscores also showed improvement post-rTMS. The presented case study provides preliminary evidence that rTMS may be a noninvasive treatment option for improving balance, specifically in individuals with MdDS. This evidence can be used to further therapeutic research on, and provide strategies for treating, MdDS. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.