Driving restrictions for patients with seizures and epilepsy
- Allan Krumholz, MD
Allan Krumholz, MD
- Professor of Neurology
- University of Maryland School of Medicine
- Jennifer Hopp, MD
Jennifer Hopp, MD
- Associate Professor of Neurology
- University of Maryland School of Medicine
While much remains uncertain and is controversial about driving and epilepsy, it is generally agreed that:
●A patient with uncontrolled epilepsy who drives is at risk for a motor vehicle crash with resulting property damage as well as injury or death to himself and others.
●For many adults, restrictions on driving place severe limitations on their ability to participate in school, employment, and social activities and therefore significantly diminish independence and quality of life.
These statements represent the conflict that this issue poses between the interests of public health and safety versus the promotion of opportunities and optimal quality of life for patients with epilepsy. When asked about the impact of epilepsy on their quality of life, patients list driving as their top concern [1,2]. Current regulations and guidelines try to balance these potentially conflicting goals.
Driving restrictions for patients with epilepsy date back to the first issuance of drivers' licenses, when patients with epilepsy were essentially banned from driving . With the development of effective antiseizure drugs, and the recognition that many patients with epilepsy were well controlled and therefore at low risk for seizures while driving, laws have been successively revised to relax this total restriction.
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- MAGNITUDE OF RISK
- RISK FACTORS FOR SEIZURE-RELATED CRASHES
- Seizure-free interval
- Discontinuing medication
- Other risk factors
- Nonseizure-related risk
- MITIGATING FACTORS
- Single unprovoked seizure
- Acute symptomatic seizure
- Focal seizures
- LEGAL REQUIREMENTS
- Clinicians' responsibility
- Patients' responsibility
- Commercial drivers
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS