Motion Sickness and Psychological and Vestibular Symptom Burden after Concussion

Given the potential interplay of psychological symptoms following pediatric concussion and vestibular dysfunction, we conducted a prospective cohort study of participants ages 8 to 19 ≤72 hours of injury from the emergency department to assess the association between motion sickness and outcomes. Participants completed visio-vestibular testing and symptom-based surveys at enrollment, with outcome assessment at 1 and 4 weeks post-injury. We enrolled 114 participants, 19 with motion sickness history, 17 with new motion sickness after injury. Although not statistically significant following Bonferroni correction, those who developed motion sickness following concussion had higher total enrollment symptom scores (median 42 vs 21, P = .015), more missed school days (median 8 vs 3, P = .043), and a higher incidence of symptoms above baseline at 4 weeks (63.6% vs 38.9%, P = .181). Those with new motion sickness may be vulnerable to poorer outcomes after concussion, indicating potential value in motion sickness screening at presentation and vestibular-focused therapies.