Phantom earthquake syndrome presenting with chronic dizziness after an earthquake: A case report

Phantom earthquake syndrome is a rare condition seen in earthquake survivors characterized by false sense of earthquake-like motion (phantom earthquake sensations) with vegetative and motor symptoms, even though there was not any recorded earthquake by available earthquake registry. Here, we report first documented case of phantom earthquake syndrome in Turkey following the Maraş, Turkey 2023 earthquake which had presented with persistent dizziness following earthquake despite 3-month course of betahistine dihydrochloride therapy and was successfully treated with vestibular rehabilitation, lifestyle modifications and vitamin D supplementation.

A 44-year-old female patient was referred to our Family Medicine General Check-Up Clinic with complaints of persistent general weakness, diffuse body aches, and dizziness lasting over the previous 6 months following the Maraş, Turkey 2023 earthquake in spite of 3 months course of medical therapy.

The patient's dizziness was independent of recorded aftershocks and was characterized by sensations of ground movement and earthquake-like vibrations, resulting in functional impairment due to anxiety. Comprehensive physical examination, including neurological, ophthalmological, and otoscopic evaluations, revealed no abnormalities. Laboratory studies indicated marginally elevated LDL cholesterol and triglycerides, along with slightly reduced vitamin D and thyroid-stimulating hormone levels. Cranial and cervical MRI, as well as carotid artery Doppler ultrasonography, yielded normal findings. These findings align with phantom earthquake syndrome.

Initial management by a neurologist with a 3-month course of betahistine dihydrochloride (2 × 24 mg) did not improve our patient's symptoms. Upon the fact the patient's earthquake experience which the patient mentioned for the first time on further history-taking along with her laboratory and imaging findings, betahistine dihydrochloride was discontinued and a treatment plan which is focusing on symptomatic relief with exercise and vestibular rehabilitation, along with vitamin D supplementation was initiated.

After 1 month, the patient's symptoms subsided and her biochemical and hematological parameters were within normal ranges with exercise and vestibular rehabilitation, along with vitamin D supplementation.

This case contributes to diagnose phantom earthquake syndrome as a psychosomatic response to disaster which highlights the significance of further history-taking and non-pharmacological treatments like exercise and vestibular rehabilitation for alleviating symptoms.