Driving Restrictions for People With Epilepsy Still Debatable
WebMD News Archive
Nov. 16, 1999 (New York) -- Patients with epilepsy who drive have the best
chance of avoiding a seizure-related car crash if they have not had a seizure
in at least 6-12 months, according to a report in the medical journal
The research team, headed by Gregory L. Krauss, MD, of Johns Hopkins
University in Baltimore, found that compared to patients with shorter
intervals, those who had seizure-free intervals of 12 months or more had a 93%
reduction in the risk of an accident, and those with seizure-free periods of 6
months or more had an accident-risk reduction of 85%.
Having reliable auras that served as warnings to stop driving also
significantly reduced the risk of an accident; however, 26% of patients had
crashes despite having auras.
Having few prior motor vehicle accidents not related to seizures also
reduced the chances that people with epilepsy would be involved in a crash.
Surprisingly, patients whose anti-epilepsy drugs were reduced or switched also
had a lower risk of a seizure-related crash.
"[We had thought] that people whose medicines are switched or reduced
will crash more, but in fact, it turned out to be the other way around,"
Krauss tells WebMD. "Some people did crash after changing medicine, but the
bulk of the group seemed to have a protective effect from changing medication.
Many of those people [had been] under-dosed, or their medication wasn't working
properly, so the changes in medication most likely controlled their seizures
better, protecting them from a seizure-related crash."
The 50 "cases" -- people with epilepsy who had car crashes during
seizures -- and the 50 "controls" with epilepsy who did not, were
matched by age and sex and were from the same clinic. There was no significant
difference in the study findings based on seizure types, driving experience, or
types of roads used.
Krauss and colleagues say a good approach to lowering the rate of
seizure-related crashes may be to emphasize to physicians and patients the need
to optimize anti-epilepsy drug therapy, with the goal of achieving longer
An editorial in the same issue, commenting on the study, points out that
other attempts to come up with appropriate driving restrictions for people with
seizures and epilepsy have come to very different conclusions. For example, a
recent workshop of the European Union Association of International Bureau for
Epilepsy recommended a mandatory 1-year seizure-free period before driving,
while a U.S. workshop conference recommended a minimum 3-month seizure-free