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- Should people with epilepsy be allowed to drive?
- What regulations apply for people with epilepsy?
- Which drivers with epilepsy are the safest?
- Precautions
- Remember
Driving And Epilepsy
To drive or not to drive?
This seems to be the question for people with Epilepsy - another aspect that affects their daily lives.
Should people with Epilepsy be allowed to drive?
Driving is a risky business for anyone. The magnitude of the risk of driving is, determined by the driver’s age and the level of responsibility regarding their driving skills and their health condition.
Health problems such as diabetes, stroke, heart disease, head injuries and infections of the nervous system are all risk related factors that can influence a person’s ability to drive. Epilepsy is only one health related condition that carries a risk factor for driving.
What regulations apply for people with Epilepsy?
In South Africa there is no law regarding the driving of a vehicle by a person who has Epilepsy, although provincial authorities have a set of guidelines and the person with Epilepsy should check these out.
In general the decision of whether a person with Epilepsy should drive or not drive is based on the severity of the persons Epilepsy and the degree of seizure control. Major neurological centers in South Africa adopted the following principals:
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A person should not drive for six months after the first seizure
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A two year seizure free period should elapse before driving a public or heavy vehicle
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Regular follow-up examinations by the neurologist are essential and compliance with prescribed treatment and accurate reporting of seizures, a must!
Which drivers with Epilepsy are the safest?
One of the oldest but best epidemiological studies in literature determined that the riskiest drivers with Epilepsy were those with “deviant attitudes”. These individuals were the most non-compliant with their prescribed medication and were the most likely to drive without a license.
Accident risk stratification must be individualized:
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Those with a prior car crash due to a seizure are the most worrisome and may need a longer seizure-free period interval before resuming driving.
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Those with Epilepsy and abusing alcohol are clearly at greater risk.
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Those who do not comply with physician guidelines are dangerous on the roads.
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Those with structural brain lesions face increased risks.
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Those with clusters of seizures, despite long seizure free intervals poses an unpredictable risk.(The last two mentioned are largely controllable with medication monitoring)
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Those with seizures without a loss of consciousness, an established pattern of nocturnal seizures and those with consistent and prolonged auras have much less risks.
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People with an isolated breakthrough seizure traceable to a medication problem or inter-current illness are much safer drivers because of their level of responsibility towards their own health condition.
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People who undergo a supervised change in medication should understand the need to minimize their driving as much as possible, during this period.
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People with Epilepsy who comply with driving regulations regarding seizure free intervals pose no or little increased risk of accidents.
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In another study done in England it was found that the rate of accidents among drivers with Epilepsy, not related to their seizures, was lower than the general accident rate, suggesting that these motorists may be more cautious on the road.
Precautions
Once you are able to drive there are some important things to do / know:
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Check that your insurance policies are valid – inform your insurer of your condition
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If your work is going to involve driving, inform your employer.
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Don’t drive sooner than 12 hours after the consumption of even one drink of alcohol.
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When you change or stop your medication suddenly, stop driving until a doctor advises you are safe
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If you have a seizure for the first time in years, stop driving and consult your doctor. The same applies to those people who have nocturnal seizures (sleep Epilepsy) who suddenly have a seizure while awake
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You are more likely to have a seizure when you are overtired or ill.
Remember
Driving is considered a privilege, and therefore, people are licensed to drive. In granting that privilege, society theoretically weighs the risk to the public of granting the license, against the benefits to the individual, of being able to drive.
Any person with a drivers licence (with or without Epilepsy) has a responsibility towards the safety of society and him/herself and should regard this privilege with great concern