Driving and epilepsy

Appaji Rayi MD (

Dr. Rayi of West Virginia University, Charleston Division has no relevant financial relationships to disclose.

)
Muhammad Taimoor Khan MD (

Dr. Khan of West Virginia University has no relevant financial relationships to disclose.

)
Konark Malhotra MD (

Dr. Malhotra of West Virginia University, Charleston Division has no relevant financial relationships to disclose.

)
David Gloss MD (

Dr. Gloss, Director of Epilepsy of the Geisinger Health System, has no relevant financial relationships to disclose.

)
John M Stern MD, editor. (Dr. Stern, Director of the Epilepsy Clinical Program at the University of California in Los Angeles, received honorariums from Sunovion and UCB as an advisor and from Cyberonics, Eisai, Lundbeck, and UCB as a lecturer.)
Originally released January 11, 2018; expires January 11, 2021

Overview

People with epilepsy are at increased risk of impaired driving. In this article, the authors provide an overview of issues related to driving for people with epilepsy. Epilepsy affects driving capability due to the paroxysmal nature of the disorder and associated impaired cognition, which may result in loss of vehicle control. It is estimated that people with epilepsy are 1.13 to approximately 2.16 times more likely to be involved in a motor vehicle accident compared to people without epilepsy (Federal Motor Carrier Safety Administration 2007). One study observed that approximately 0.2% of all motor vehicle accidents are related to seizures, more than all other medical conditions, including cardiovascular diseases and diabetes (Sheth et al 2004). Adding the factors of young driving age (25 years and younger) and alcohol consumption increased the risk of fatal motor vehicle accident by 8 times. Among people with medication-resistant epilepsy, restriction from driving is universally accepted as a means to protect the public and the people with epilepsy themselves from driving-related accidents despite the capability to drive being important for both personal and professional life (Gilliam et al 1997). State and federal regulators weigh individual needs versus the potential safety issues and make judgments depending on local factors. The period of restriction varies widely, as there are no clear scientific data to indicate a standard duration. Physicians play an important role in the medical opinion, counseling, and decision-making regarding driving privileges for people with epilepsy.

Key points

 

• About 1 in 500 driving-related fatalities is related to seizures.

 

• Driving restriction periods in people with epilepsy are not uniform and vary widely across jurisdictions.

 

• Physicians should know their local driving laws.

 

• Physicians, patients, and regulating bodies together are responsible for the safety of people with epilepsy with regard to driving.

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