LIVING WITH EPILEPSY: DRIVING AND EPILEPSY – CONTROLLING

Individuals who have epilepsy controlled with medication and whose physicians are now recommending discontinuing medication pose special dilemmas for both the physician and the driver. Optimally, we would like to help patients be free of medication if possible. While in an ideal patient the risk of recurrent seizures is small, if they recur it is most likely to happen in the first three to six months after stopping medication. Most physicians recommend that the patient should not drive during that period of increased risk. If driving is absolutely essential, then risks should be minimized by limiting the amount of time behind the wheel. Driving while tired or for long distances should be avoided during this period.
Clearly there is need for better information on the risks of driving with epilepsy. Such information should assess the risks of recurrence of seizures and factors which are predictive of such a recurrence, as well as the risks and hazards of accidents and of injuries to others. These risks should be placed in the perspective of other health-related disabilities. The driving risks represented by persons who use drugs and alcohol far outweigh the risks associated with epilepsy. These factors should be considered by the regulating agency when deciding whose driving should be restricted and for how long. The availability of restricted licenses that might permit an individual to drive to work or to school or only under certain restricted circumstances might balance the public’s risk of allowing some people with epilepsy to drive against the high cost of restricting the privilege.
Above all, decisions about driving need to be based on individual needs and capacities.
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