When Are Parkinson's Patients a Risk on the Road?
May 8, 2000 -- Laura Liggett is 45 years old and "retired," as she
calls it -- not by choice, but at her doctor's suggestion. Liggett has
Parkinson's disease, a degenerative disorder of the central nervous system,
which interferes with many daily activities, not the least of which is
"Really there's only a small window where I drive, as I would say,
normally," Liggett tells WebMD. "Normally" means without her
reactions being slowed, spastic, or worse. "This one medication I take
makes me really sleepy, and there was at least one time when I nodded off and I
woke up in a different lane than I was in before," says the Marietta, Ga.,
resident, who has been on medication for the disease for 11 years.
Although the effects of the disease vary widely from patient to patient,
Liggett's situation is like that of hundreds of thousands of Parkinson's
patients who know that sooner or later, they may have to decide whether their
driving is a hazard to themselves and others.
Parkinson's disease is caused by a gradual deterioration of nerves in a
region of the brain that controls movement. In later stages, there may be some
intellectual deterioration and memory loss. Driving difficulties can be brought
on by many factors, including sleepiness caused by drugs to treat the disease
as well as the physical problems themselves.
"There's been a lot of discussion in the last year or two regarding the
safety of patients with Parkinson's disease in terms of their driving,
particularly as it relates to the use of certain medications that could perhaps
cause them to become very drowsy and suddenly fall asleep," Erwin
Montgomery, MD, tells WebMD. Montgomery is director of the movement disorders
program at the Cleveland Clinic Foundation in Ohio.
One study looking at the safety of driving for Parkinson's patients was
presented at the annual meeting of the American Academy of Neurology in San
Diego last week. The study's goals, writes researcher Theresa A. Zesiewicz, MD,
were both to evaluate the driving ability of Parkinson's patients and to
determine which variables might serve as predictors of unsafe driving in these
patients. Zesiewicz is with the Parkinson's Disease and Movement Disorders
Center at the University of South Florida College of Medicine in Tampa.
Finding those variables may prove to be the tricky part, says Abraham
Lieberman, MD, medical director for the National Parkinson's Foundation.
Setting guidelines for who should and shouldn't drive with Parkinson's,
Lieberman tells WebMD, "is a very difficult task, and it may be an almost
impossible task. ? There are no established guidelines for this because I think
the nature of the problem is so complicated ? you can't make a blanket
Still, Lieberman says, "I applaud a study like this because somebody's
got to start to lay out the nature of the problem."