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Post-Earthquake Dizziness Syndrome: Understanding, Coping, and Managing

Writer: MaytaMayta

Overview

In the aftermath of a significant seismic event, such as the M7.7 earthquake on March 28 affecting Myanmar, Thailand, and neighboring countries, many individuals report a lingering sensation of dizziness, vertigo, or imbalance. This phenomenon, often referred to as Post-Earthquake Dizziness Syndrome (PEDS) or "Jishin-yoi" (地震酔い) in Japanese (literally “earthquake sickness”), is a recognized condition triggered by sensory mismatch and psychological stress.

 

What Causes Dizziness After an Earthquake?

1. Sensory Conflict Mechanism

Your body relies on three systems to maintain balance:

  • Visual system (eyes)

  • Vestibular system (inner ear)

  • Somatosensory system (proprioception)

During an earthquake, these systems receive conflicting sensory information:

  • Your inner ear may detect movement.

  • Your eyes may see stillness.

  • Your body may feel vibrations inconsistently.

This mismatch leads to cerebral confusion, producing symptoms like:

  • Vertigo (spinning sensation)

  • Disequilibrium (off-balance feeling)

  • Lightheadedness or motion sickness

This is similar to what people experience during seasickness or virtual reality disorientation.

2. Psychological Contributors

Stress, anxiety, and fear during or after a disaster activate the autonomic nervous system, triggering:

  • Hyperventilation

  • Increased adrenaline

  • Muscle tension

These can further exacerbate feelings of dizziness and bodily discomfort, creating a psychosomatic loop where fear fuels physical symptoms.

 

Recognizing the Symptoms of PEDS

Symptoms may appear hours to days after the event and include:

  • Sensation of swaying or rocking, especially while stationary

  • Difficulty concentrating or unsteady gait

  • Anxiety or panic episodes

  • Nausea or mild headaches

  • Fatigue or a sense of "floating"

These symptoms are generally self-limited but can persist if unmanaged.

 

Who Is More at Risk?

  • Women aged 30–50 (possibly due to hormonal sensitivity)

  • Individuals with migraine history or motion sickness

  • People with vestibular disorders or inner ear problems

  • Those who were in high-rise buildings during the quake

  • People experiencing high anxiety or PTSD

 

What Can You Do?

Self-Care and Immediate Relief

  • Focus on a fixed point: Helps stabilize visual-vestibular conflict.

  • Close your eyes and breathe deeply: Reduces sensory input and calms the nervous system.

  • Stay hydrated: Dehydration worsens dizziness.

  • Lie down in a safe place: Avoid falls during sudden vertigo.

  • Sleep well: Rest helps the brain recalibrate.

Over-the-Counter Medications (Supportive Treatment)

If symptoms persist or are disruptive:

  • Dimenhydrinate (Dramamine): 50 mg po tid prn for motion sickness

  • Meclizine: 25 mg po bid prn for vertigo

⚠️ Use with caution in the elderly due to sedation. Do not drive or operate machinery while medicated.
 

When to See a Doctor?

Seek medical evaluation if:

  • Dizziness is worsening or persistent beyond 1–2 weeks

  • You experience true vertigo (room spinning), hearing loss, or tinnitus

  • There are signs of inner ear damage (e.g., from trauma)

  • There's a history of neurological disorders

  • You have difficulty walking, double vision, or slurred speech (rule out central causes)

In rare cases, central vestibular causes or stroke should be excluded with neurological examination and imaging.
 

Management Summary Table

Problem

Type

Management

Medication Example

Post-Earthquake Dizziness Syndrome

Supportive

Focus on sensory integration, rest, hydration, and reassurance

Dimenhydrinate 50 mg po tid prn

Stress/Anxiety Component

Supportive

Mindfulness, breathing exercises, short-term anxiolytics if needed

Diazepam 2 mg po hs prn (short term)

Persistent Vertigo

Definitive

Refer to ENT for vestibular testing ± imaging

Meclizine 25 mg po bid prn

 

Public Health Advice

  • Educate your community that this reaction is common and usually harmless.

  • Encourage those affected to talk about their experience and seek mental health support if necessary.

  • Avoid stigmatizing dizziness as weakness or exaggeration—it's neurophysiologically real.


 

Conclusion

Post-Earthquake Dizziness Syndrome is a real, often under-recognized response to seismic trauma. Understanding its pathophysiology and management empowers survivors to cope and recover better. While it’s mostly benign, persistent or atypical symptoms deserve thorough evaluation to rule out inner ear or neurological disease.

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Post: Blog2_Post

Message for International Readers
Understanding My Medical Context in Thailand

By Uniqcret, M.D.
 

Dear readers,
 

My name is Uniqcret, which is my pen name used in all my medical writings. I am a Doctor of Medicine trained and currently practicing in Thailand, a developing country in Southeast Asia.
 

The medical training environment in Thailand is vastly different from that of Western countries. Our education system heavily emphasizes rote memorization—those who excel are often seen as "walking encyclopedias." Unfortunately, those who question, critically analyze, or solve problems efficiently may sometimes be overlooked, despite having exceptional clinical thinking skills.
 

One key difference is in patient access. In Thailand, patients can walk directly into tertiary care centers without going through a referral system or primary care gatekeeping. This creates an intense clinical workload for doctors and trainees alike. From the age of 20, I was already seeing real patients, performing procedures, and assisting in operations—not in simulations, but in live clinical situations. Long work hours, sometimes exceeding 48 hours without sleep, are considered normal for young doctors here.
 

Many of the insights I share are based on first-hand experiences, feedback from attending physicians, and real clinical practice. In our culture, teaching often involves intense feedback—what we call "โดนซอย" (being sliced). While this may seem harsh, it pushes us to grow stronger, think faster, and become more capable under pressure. You could say our motto is “no pain, no gain.”
 

Please be aware that while my articles may contain clinically accurate insights, they are not always suitable as direct references for academic papers, as some content is generated through AI support based on my knowledge and clinical exposure. If you wish to use the content for academic or clinical reference, I strongly recommend cross-verifying it with high-quality sources or databases. You may even copy sections of my articles into AI tools or search engines to find original sources for further reading.
 

I believe that my knowledge—built from real clinical experience in a high-intensity, under-resourced healthcare system—can offer valuable perspectives that are hard to find in textbooks. Whether you're a student, clinician, or educator, I hope my content adds insight and value to your journey.
 

With respect and solidarity,

Uniqcret, M.D.

Physician | Educator | Writer
Thailand

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