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Motorist's Disorientation Syndrome-A Narrative Review
Georges Dumas1,2, Pierre Denise3, Art Mallinson4
1Research Unit DevAH-Development, Adaptation and Handicap, Faculty of Medicine, University of Lorraine, 54500 Vandoeuvre-lès-Nancy, France.
Journal of Functional Morphology and Kinesiology
|June 25, 2026
Summary
Motorist's disorientation syndrome (MDS) causes driving-related vertigo due to visual-vestibular conflicts. This review details MDS symptoms, associated conditions like anxiety and migraine, and differentiates it from similar dizziness disorders.
Area of Science:
- Neuroscience
- Ophthalmology
- Vestibular System Disorders
Background:
- Motorist's disorientation syndrome (MDS), or visual vertigo, affects 1-5% of patients in neurotology clinics.
- First described in 1985, MDS involves disorientation during driving, particularly with restricted visual input or specific road conditions.
- It is often associated with peripheral or central neurotological abnormalities and exaggerated optokinetic responses.
Purpose of the Study:
- To delineate the symptoms and precipitating situations of Motorist's disorientation syndrome (MDS).
- To discuss associated pathologies, such as anxiety and migraine, and differentiate MDS from persistent postural-perceptual dizziness (PPPD) and motion sickness (MS).
- To explore the role of vestibular assessments, including otolith organs, semicircular canals, and optokinetic stimulation.
Main Methods:
- A narrative review analyzing eight publications on Motorist's disorientation syndrome (MDS).
- Literature search focused on symptoms, precipitating factors, associated conditions, and differential diagnoses.
- Examination of vestibular assessment findings, including optokinetic stimulation and orthoptic evaluations.
Main Results:
- MDS stems from visual-vestibular or visio-visual conflict, affecting drivers of all genders.
- Associated conditions include anxiety (17-39%), migraine history (50-62%), and convergence/strabismic problems.
- Mild vestibular abnormalities or exaggerated optokinetic responses occur in 60-100% of cases; symptoms typically resolve in 6 years, longer in females.
Conclusions:
- MDS is a multifactorial condition, sharing similarities with some PPPD forms but distinct from MS.
- The pathophysiology may involve the velocity storage integrator; further research is needed.
- Promising treatments include vestibular rehabilitation, virtual reality, CBT, and orthoptic therapy.
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