UAE - For 46-year-old R.V., his job as a sales manager requires him to drive for hundreds of kilometres every week to meet clients.

However, when he started developing dizziness, palpitation and body stiffness while driving, his entire career was at stake. With over 22 years of experience on the roads, the man was at a loss as to why he would get these symptoms every day when he drove.

A visit to neurologist Dr. Vishal Pawar at the Vertigo Clinic in Aster Clinic, Discovery Gardens, Dubai, revealed that R.V. was suffering from an under-reported condition called Motorist’s Vestibular Disorientation Syndrome (MVDS). First reported in 1985 when a paper was written on it, MVDS has since been largely forgotten with very little literature about it – the disease often gets misdiagnosed.

Dr. Vishal, who has been diligently monitoring patients for the last four years at the vertigo clinic, said that he started noticing a pattern in many of his patients. “Many experienced palpitations, dizziness, stiffness and other symptoms while driving,” he said.

“Curiously, none of them were new drivers. They had been driving for at least five years before they experienced these issues. That is when I realized that they were showing classic symptoms of MVDS.”

Now, Dr. Vishal is preparing to publish a paper with case studies of over 24 patients who have been diagnosed with MVDS in the last 4 years. He hopes that this will raise awareness about the disease and help other doctors recognise the signs of the disease. He said that some of his patients had consulted up to eight doctors who had not been able to diagnose their issue.

Common characteristics

Dr. Vishal said that many of his patients had reported common characteristics. “Most of them developed symptoms at higher speed of 80 kmph or more,” he said. “They also developed these issues at bends and turns or on multi lane roads, especially on the high-speed lane. Many also exhibited symptoms on upward or downward slopes or when overtaking big vehicles.”

According to Dr. Vishal, part of the problem arises when the brain is not coordinated enough to perform all the functions necessary to drive.

“Driving is a complex cognitive skill that is learnt,” he said. “The nature of driving especially in the UAE is very dynamic, with wide highways and high speeds. A variety of parts of the brain are involved in driving. We need higher cognitive function, we need to know where we are heading, memory, vision, power, sensory system and use our cerebellum.”

He said that when patients feel discomfort, they try to compensate. “When the patients feel dizzy or disoriented when driving, they try to make postural adjustments. When that doesn’t work, then they start to panic. Many of them often have to pull over and relax for a while before they can continue on with their journey.”

Treatment

For R.V., his treatment involved taking prescribed medication, supplemented by vestibular physiotherapy with virtual reality goggles. He also received counselling from a psychologist. Over the course of 2 years, he experienced significant improvement in his symptoms, allowing him to drive without any issues.

Dr. Vishal said that in most cases a combination of drugs, counselling and rehabilitation including playing car simulation games often helped his patients to recover and continue driving without issues.

Although there is no indication of what brings the onset of MVDS, Dr. Vishal said that more that pre-existing conditions like anxiety, migraine and motion sickness had some role to play in several of his case studies.

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