Motorist's Vestibular Disorientation Syndrome (MVDS)-Proposed Diagnostic Criteria

Area of Science:

• Neuroscience
• Otolaryngology
• Transportation Safety

Background:

• Motorist's vestibular disorientation syndrome (MVDS) is an under-reported condition causing driving-related dizziness.
• It frequently goes unrecognized in clinical practice, impacting professional drivers.
• Understanding MVDS is crucial for driver safety and accurate diagnosis.

Purpose of the Study:

• To identify the clinical characteristics of patients diagnosed with Motorist's vestibular disorientation syndrome (MVDS).
• To explore precipitating factors, co-morbidities, and treatment responses in MVDS patients.
• To propose a classification system and diagnostic criteria for MVDS.

Main Methods:

• Retrospective review of clinical data from 24 diagnosed MVDS patients.
• Analysis of symptoms, illness duration, triggers, co-morbidities, and neuro-otological history.
• Ocular motor movements assessed via video-nystagmography; similar vestibular disorders were excluded.

Main Results:

• Most patients (79.2%) experienced disorientation exclusively while driving, with common triggers including high speeds (>80 km/h) and multi-lane roads.
• Migraine history (62.5%) and motion sickness (50%) were prevalent; anxiety (34.3%) and depression (15.7%) were also noted.
• Video-nystagmography showed no specific abnormalities; patients responded to migraine prophylactics and certain anticonvulsants.

Conclusions:

• MVDS is characterized by driving-specific disorientation, often linked to migraines and motion sickness.
• Effective treatments involve migraine prophylactic medications and anticonvulsants like Pregabalin.
• Proposed diagnostic criteria and classification system aim to improve recognition and management of MVDS.