{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T14:26:07Z","timestamp":1787063167287,"version":"build-2736575974"},"reference-count":50,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"M\u00e9tropole du Grand Nancy\/Metropolitan Community of Nancy"},{"id":[{"id":"https:\/\/ror.org\/05ncw0t52","id-type":"ROR","asserted-by":"publisher"}]},{"name":"Grand Est Region, northeastern France"},{"name":"Scientific Council"},{"name":"Faculty of Science and Techniques of Physical and Sport Activities of the University of Lorraine"},{"id":[{"id":"https:\/\/ror.org\/04vfs2w97","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JFMK"],"abstract":"<jats:p>Motorist\u2019s disorientation syndrome (MDS) is seen in 1 to 5% of patients in a tertiary neurotology clinic and remains an underdiagnosed pathology. It was first described in 1985 by Page &amp; Gresty, using the term \u201cvisual vertigo\u201d. Patients described sensations of veering or turning over while driving an automobile when visual input was restricted. This was exacerbated at high speeds, on winding roads, going down hills, or when overtaken by a vehicle. All patients in this initial study had peripheral or central neurotological abnormalities and showed exaggerated responses during optokinetic stimulation. Some sufferers considered giving up driving. The first aims of this narrative review were to delineate the symptoms of MDS as detailed in the literature, to outline precipitating situations and to discuss associated pathologies such as anxiety. The second aim was to differentiate MDS from similar syndromes, such as persistent postural-perceptual dizziness (PPPD) and motion sickness (MS). In addition, we looked at the role of vestibular assessments and discussed the involvement of the otolith organs and semicircular canals. In this review, eight publications were analyzed. MDS is related to a visual-vestibular or a visio-visual conflict and occurs in drivers (both males and females). It is associated with anxiety in 17\u201339% of cases. Mild vestibular-test abnormalities or exaggerated response to opto-kinetic stimulations are seen in 60\u2013100% of cases. Between 50 and 62% of patients have a migraine history. Convergence and strabismic problems are also often seen. Symptoms usually settle after 6 \u00b1 4 years but can persist for longer in females. MDS is multifactorial, and similar to certain forms of PPPD but different than MS. Its pathophysiology is still in question, and we support the role of the velocity storage integrator as a recent hypothesis. Treatment includes vestibular rehabilitation, virtual reality, cognitive behavioral therapies and orthoptic sessions, and the results are promising. The authors also strongly feel that future research on clarifying MDS pathology should study a wider scope of vestibular assessments to evaluate semicircular canal\/otolithic function, as well as the vestibulo-ocular reflex, analyze optokinetic nystagmus time constant, and perform a systematic orthoptic examination.<\/jats:p>","DOI":"10.3390\/jfmk11020229","type":"journal-article","created":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T18:08:07Z","timestamp":1780510087000},"page":"229","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Motorist\u2019s Disorientation Syndrome\u2014A Narrative Review"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8311-0322","authenticated-orcid":false,"given":"Georges","family":"Dumas","sequence":"first","affiliation":[{"name":"Research Unit DevAH\u2014Development, Adaptation and Handicap, Faculty of Medicine, University of Lorraine, 54500 Vandoeuvre-l\u00e8s-Nancy, France"},{"name":"Department of Oto-Rhino-Laryngology Head and Neck Surgery, University Hospital, 38043 Grenoble, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9049-7692","authenticated-orcid":false,"given":"Pierre","family":"Denise","sequence":"additional","affiliation":[{"name":"Inserm, COMETE U1075, CYCERON, Universit\u00e9 de Caen Normandie, CHU de Caen, 14000 Caen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Art","family":"Mallinson","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology, Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8230-3122","authenticated-orcid":false,"given":"Enrico","family":"Armato","sequence":"additional","affiliation":[{"name":"Research Unit DevAH\u2014Development, Adaptation and Handicap, Faculty of Medicine, University of Lorraine, 54500 Vandoeuvre-l\u00e8s-Nancy, France"},{"name":"Department of Neurosciences, University of Padova, 35100 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2327-523X","authenticated-orcid":false,"given":"Hannes","family":"Petersen","sequence":"additional","affiliation":[{"name":"Department of Anatomy, Faculty of Medicine, School of Health Sciences, University of Iceland, 102 Reykjavik, Iceland"},{"name":"Department of Surgery, Akureyri Hospital, 600 Akureyri, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4381-0850","authenticated-orcid":false,"given":"Philippe","family":"Perrin","sequence":"additional","affiliation":[{"name":"Research Unit DevAH\u2014Development, Adaptation and Handicap, Faculty of Medicine, University of Lorraine, 54500 Vandoeuvre-l\u00e8s-Nancy, France"},{"name":"Laboratory for the Analysis of Posture, Equilibrium and Motor Function (LAPEM), University Hospital of Nancy, 54500 Vandoeuvre-l\u00e8s-Nancy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1136\/jnnp.48.8.729","article-title":"Motorist\u2019s vestibular disorientation syndrome","volume":"48","author":"Page","year":"1985","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1055\/s-0040-1701653","article-title":"Visual Vertigo, Motion Sickness, and Disorientation in Vehicles","volume":"40","author":"Bronstein","year":"2020","journal-title":"Semin. Neurol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"191","DOI":"10.3233\/VES-170622","article-title":"Diagnostic criteria for persistent postural-perceptual dizziness (PPPD): Consensus document of the committee for the Classification of Vestibular Disorders of the B\u00e1r\u00e1ny Society","volume":"27","author":"Staab","year":"2017","journal-title":"J. Vestib. Res."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"339","DOI":"10.3233\/VES-220088","article-title":"Motorist disorientation syndrome; clinical features and vestibular findings","volume":"33","author":"Ainsworth","year":"2023","journal-title":"J. Vestib. Res."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Pawar, V., Ashraf, H., Dorsala, S., Mary, P., Hameed, N., H, D.N., Adatia, S.P., Raj, L., Ananthu, V.R., and Shouka, M. (2023). Motorist\u2019s Vestibular Disorientation Syndrome (MVDS)-Proposed Diagnostic Criteria. J. Pers. Med., 13.","DOI":"10.3390\/jpm13050732"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1097\/WCO.0000000000001018","article-title":"Motion sickness: Current concepts and management","volume":"35","author":"Keshavarz","year":"2022","journal-title":"Curr. Opin. Neurol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1111\/cns.12468","article-title":"Motion Sickness: Current Knowledge and Recent Advance","volume":"22","author":"Zhang","year":"2016","journal-title":"CNS Neurosci. Ther."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1097\/00019052-200502000-00007","article-title":"Motion sickness","volume":"18","author":"Golding","year":"2005","journal-title":"Curr. Opin. Neurol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"203","DOI":"10.3233\/VES-130501","article-title":"Motion sickness susceptibility in healthy subjects and vestibular patients: Effects of gender, age and trait-anxiety","volume":"23","author":"Paillard","year":"2013","journal-title":"J. Vestib. Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1055\/s-0033-1354602","article-title":"Vertigo and dizziness from environmental motion: Visual vertigo, motion sickness, and drivers\u2019 disorientation","volume":"33","author":"Bronstein","year":"2013","journal-title":"Semin. Neurol."},{"key":"ref_11","first-page":"145","article-title":"Balance in elderly subjects","volume":"1993","author":"Freyss","year":"1994","journal-title":"Contrib. Instrupental."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Feller, K.J., Peterka, R.J., and Horak, F.B. (2019). Sensory Re-weighting for Postural Control in Parkinson\u2019s Disease. Front. Hum. Neurosci., 13.","DOI":"10.3389\/fnhum.2019.00126"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"414","DOI":"10.4300\/JGME-D-22-00480.1","article-title":"Narrative Reviews: Flexible, Rigorous, and Practical","volume":"14","author":"Sukhera","year":"2022","journal-title":"J. Grad. Med. Educ."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"517","DOI":"10.11124\/JBIES-24-00308","article-title":"Update to the PRISMA guidelines for network meta-analyses and scoping reviews and development of guidelines for rapid reviews: A scoping review protocol","volume":"23","author":"Veroniki","year":"2025","journal-title":"JBI Evid. Synth."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"41","DOI":"10.3389\/fneur.2017.00041","article-title":"The Skull Vibration-Induced Nystagmus Test of Vestibular Function-A Review","volume":"8","author":"Dumas","year":"2017","journal-title":"Front. Neurol."},{"key":"ref_17","unstructured":"Gresty, M.A., and Ohlmann, T. (2002, January 15\u201317). Motorists Vestibular Disorientation Syndrome Revisited. Proceedings of the RTO HFM Symposium on \u201cSpatial Disorientation in Military Vehicles: Causes, Consequences and Cures\u201d, La Coru\u00f1a, Spain."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"45","DOI":"10.3109\/00016489509125186","article-title":"The visual vertigo syndrome","volume":"520","author":"Bronstein","year":"1995","journal-title":"Acta Otolaryngol. Suppl."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1007\/s00415-004-0410-7","article-title":"Vision and vertigo: Some visual aspects of vestibular disorders","volume":"251","author":"Bronstein","year":"2004","journal-title":"J. Neurol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1646","DOI":"10.1093\/brain\/124.8.1646","article-title":"Visual vertigo: Symptom assessment, spatial orientation and postural control","volume":"124","author":"Guerraz","year":"2001","journal-title":"Brain"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1177\/09574271251313803","article-title":"The International Classification of Vestibular Disorders: Achievements, challenges, and future directions","volume":"35","author":"Kaski","year":"2025","journal-title":"J. Vestib. Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.mehy.2018.04.025","article-title":"Visual vertigo: Vertigo of oculomotor origin","volume":"116","author":"Chin","year":"2018","journal-title":"Med. Hypotheses"},{"key":"ref_23","unstructured":"Mallinson, A. (2011). Visual Vestibular Mismatch: A Poorly Understood Presentation of Balance System Disease. [Doctoral Thesis, Maastricht University]."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1177\/014556130208100606","article-title":"A patient with ear pain who had panic attacks while driving over bridges and in wide-open spaces","volume":"81","author":"Brookler","year":"2002","journal-title":"Ear Nose Throat J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1093\/bmb\/63.1.213","article-title":"Underrated neuro-otological symptoms: Hoffman and Brookler 1978 revisited","volume":"63","author":"Bronstein","year":"2002","journal-title":"Br. Med. Bull."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1177\/014556130208100306","article-title":"A patient who had difficulty moving her head and looking at a computer screen","volume":"81","author":"Brookler","year":"2002","journal-title":"Ear Nose Throat J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1177\/014556130208100406","article-title":"Electronystagmography in a patient who could not drive more than 5 minutes at highway speeds","volume":"81","author":"Brookler","year":"2002","journal-title":"Ear Nose Throat J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"130","DOI":"10.3357\/AMHP.4946.2018","article-title":"Intravestibular Balance and Motion Sickness","volume":"89","author":"Previc","year":"2018","journal-title":"Aerosp. Med. Hum. Perform."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1016\/S0361-9230(98)00091-4","article-title":"Motion sickness susceptibility questionnaire revised and its relationship to other forms of sickness","volume":"47","author":"Golding","year":"1998","journal-title":"Brain Res. Bull."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.autneu.2006.07.019","article-title":"Motion sickness susceptibility","volume":"129","author":"Golding","year":"2006","journal-title":"Auton. Neurosci."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"473","DOI":"10.3357\/ASEM.3523.2013","article-title":"Motion sickness in rally car co-drivers","volume":"84","author":"Perrin","year":"2013","journal-title":"Aviat. Space Environ. Med."},{"key":"ref_32","unstructured":"Perrin, C., Conraux, C., Collard, C., Freyss, G., and Sauvage, J.P. (1987). L\u2019\u00e9quilibre en Pesanteur et Impesanteur, Arnette."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"986","DOI":"10.1016\/S0140-6736(96)90140-3","article-title":"Visual vertigo","volume":"347","author":"Sawle","year":"1996","journal-title":"Lancet"},{"key":"ref_34","unstructured":"Raphan, T., and Cohen, B. (1985). Velocity storage and the ocular response to multi-dimensional vestivular stimuli. Adaptive Mechanisms in Gaze Control, Elsevier."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1152\/jn.00485.2019","article-title":"Vestibular, locomotor, and vestibulo-autonomic research: 50 years of collaboration with Bernard Cohen","volume":"123","author":"Raphan","year":"2020","journal-title":"J. Neurophysiol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1007\/s00221-011-2568-4","article-title":"The functional significance of velocity storage and its dependence on gravity","volume":"210","author":"Laurens","year":"2011","journal-title":"Exp. Brain Res."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1293","DOI":"10.1093\/brain\/122.7.1293","article-title":"Vestibular perception of angular velocity in normal subjects and in patients with congenital nystagmus","volume":"122","author":"Okada","year":"1999","journal-title":"Brain"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1152\/jn.00154.2010","article-title":"Velocity storage contribution to vestibular self-motion perception in healthy human subjects","volume":"105","author":"Bertolini","year":"2011","journal-title":"J. Neurophysiol."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Curthoys, I.S., Zee, D.S., Dumas, G., Pastras, C.J., and Dlugaiczyk, J. (2025). Skull vibration induced nystagmus, velocity storage and self-stability. Front. Neurol., 16.","DOI":"10.3389\/fneur.2025.1533842"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Cedras, A.M., Dion, J., Saj, A., Champoux, F., and Maheu, M. (2025). Vestibular Agnosia: Toward a Better Understanding of Its Mechanisms. Audiol. Res., 15.","DOI":"10.3390\/audiolres15010015"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1331135","DOI":"10.3389\/fresc.2024.1331135","article-title":"Symptom reduction in mal de d\u00e9barquement syndrome with attenuation of the velocity storage contribution in the central vestibular pathways","volume":"5","author":"Maruta","year":"2024","journal-title":"Front. Rehabil. Sci."},{"key":"ref_42","first-page":"755","article-title":"Vestibular habituation in student pilots","volume":"60","author":"Schwarz","year":"1989","journal-title":"Aviat. Space Environ. Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"2253","DOI":"10.1097\/00001756-199807130-00019","article-title":"Motion sickness susceptibility correlates with otolith- and canal-ocular reflexes","volume":"9","author":"Quarck","year":"1998","journal-title":"NeuroReport"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1007\/s10339-004-0013-3","article-title":"The body schema and the multisensory representation(s) of peripersonal space","volume":"5","author":"Holmes","year":"2004","journal-title":"Cogn. Process."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"13847","DOI":"10.1038\/s41598-018-32238-z","article-title":"The sense of agency shapes body schema and peripersonal space","volume":"8","author":"Seriani","year":"2018","journal-title":"Sci. Rep."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1136\/jnnp.2005.075473","article-title":"Depersonalisa-tion\/derealisation symptoms in vestibular disease","volume":"77","author":"Sang","year":"2006","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"557","DOI":"10.3389\/fneur.2017.00557","article-title":"Vestibular Dysfunction and Difficulty with Driving: Data from the 2001\u20132004 National Health and Nutrition Examination Surveys","volume":"8","author":"Wei","year":"2017","journal-title":"Front. Neurol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1813","DOI":"10.1007\/s00405-021-06881-8","article-title":"Driving ability in patients with dizziness: A systematic review","volume":"279","author":"Uwents","year":"2022","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1007\/BF00232446","article-title":"Repeated optokinetic stimulation in conditions of active standing facilitates recovery from vestibular deficits","volume":"102","author":"Vitte","year":"1994","journal-title":"Exp. Brain Res."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.rfo.2025.06.004","article-title":"Regards crois\u00e9s sur un \u00ab syndrome de l\u2019autoroute \u00bb\u2013Un cas trait\u00e9 efficacement par l\u2019Orthoptie","volume":"18","author":"Bauwens","year":"2025","journal-title":"Rev. Francoph. d\u2019Orthoptie"}],"container-title":["Journal of Functional Morphology and Kinesiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2411-5142\/11\/2\/229\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T18:39:35Z","timestamp":1780511975000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2411-5142\/11\/2\/229"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,3]]},"references-count":50,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["jfmk11020229"],"URL":"https:\/\/doi.org\/10.3390\/jfmk11020229","relation":{},"ISSN":["2411-5142"],"issn-type":[{"value":"2411-5142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,3]]}}}