Epilepsy and driving

Persons with seizure disorders may be putting the public at risk from their operation of a motor vehicle. It is for this reason that most people diagnosed with epilepsy are forbidden or restricted by their local laws from operating vehicles. However, there are usually exceptions for those who can prove that they have stabilized their condition. Those few whose seizures do not cause impairment of consciousness, whose seizures only arise from sleep, or who may be able to predict their seizures in order to ensure that they do not lose consciousness behind the wheel of a moving vehicle may be exempt from such restrictions, depending on local laws. There is an ongoing debate in bioethics over "who" should bear the burden of ensuring that an epilepsy patient does not drive a car or fly an airplane or spaceship.

Laws in various places

United States

In the U.S., people with epilepsy can drive if their seizures are controlled with medication or other treatment and they meet the licensing requirements in their state. How long they have to be free of seizures varies in different states, but it is most likely to be between three months and a year.Epilepsy Foundation [http://www.epilepsyfoundation.org/answerplace/Social/driving/drivingu.cfm Driving and You - Can you drive an automobile if you have epilepsy?] .] Epilepsy Foundation [http://www.epilepsyfoundation.org/living/wellness/transportation/drivinglaws.cfm Driver Information by State] ] The majority of the 50 states place the burden on patients to report their condition to appropriate licensing authorities so that their privileges can be revoked where appropriate. A minority of states place the burden of reporting on the patient's physician. After reporting is carried out, it is usually the driver's licensing agency that decides to revoke or restrict a driver's license.

The Epilepsy Foundation's Jeanne A. Carpenter
 Epilepsy Legal Defense Fund is dedicated to advancing the rights of people with epilepsy by changing discriminatory practices, policies and laws and to ending epilepsy-related discrimination and injustice through education and increased access to legal services for individuals with epilepsy through a system of managed referrals and legal support to a nationwide network of attorneys committed to this cause.

Additionally, the Epilepsy Foundation is a vigorous advocate for people with epilepsy. In the United States, the Foundation has been active in Congress, the executive branch, and the courts, focusing attention on the needs of those with epilepsy. Priorities for the Foundation include: the availability of affordable quality health care, the search for the cure, and the protection of civil rights for people with epilepsy.

United Kingdom

In the UK, it is the responsibility of the patients to inform the Driver and Vehicle Licensing Agency (DVLA) if they have epilepsy.UK Epilepsy Action: Driving and Epilepsy, [http://www.epilepsy.org.uk/info/driving/seizure.html I've had a seizure. What should I do?] ] The DVLA rules are quite complex,UK Driver and Vehicle Licensing Agency [http://www.dvla.gov.uk/at_a_glance/content.htm Guide to the Current Medical Standards Of Fitness to Drive] . Full details for doctors regarding epilepsy are given in the [http://www.dvla.gov.uk/at_a_glance/ch1_neurological.htm#appendix Appendix] . Information for drivers can be found in [http://www.dvla.gov.uk/drivers/dmed1_files/group1.htm#nc Medical Rules - Group 1 Licence Holders] ] but in summary,UK Epilepsy Action: booklet with further details about driving [http://www.epilepsy.org.uk//download/file/78 PDF] ] those continuing to have seizures or who are within 6 months of medication change may have their licence revoked. A doctor who becomes aware that a patient with uncontrolled epilepsy is continuing to drive has, after reminding the patient of their responsibility, a duty to break confidentiality and inform the DVLA. The doctor should advise the patient of the disclosure and the reasons why their failure to notify the agency obliged the doctor to act.

weden

In Sweden, a person must be seizure-free for five years before being allowed to drive professionallyhttp://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1176346] .

Australia

Australia requires patients to be seizure-free for 3-6 months for recently-diagnosed seizures, and for two years for chronic epilepsy [http://www.epilepsyassociation.com.au/info/lifestyle/driving.html.] .

Japan

Japan has some of the world's strictest laws pertaining to epilepsy and driving, requiring all patients to be seizure-free for up to five years before being issued a license [ [http://www.ncbi.nlm.nih.gov/pubmed/1762210 A study on driving status in 98 epileptic patients... [Jpn J Psychiatry Neurol. 1991 - PubMed Result ] ] .

Flying

While most places allow people with their seizures under control to drive a car, laws regarding the operation of an airplane generally are a lot stricter. In the United States, the Federal Aviation Administration often prohibits anyone with epilepsy from being issued a pilot's license, even if the seizures are controlled by a medication or have completely ceased. The only epilepsy patients who may be issued a license are those who have had seizures during childhood, but have been seizure-free since, and have a normal EEG. Those with Rolandic seizures may be allowed to fly if seizure-free for at least 4 years. Children who have suffered a febrile seizure prior to the age of 5 may fly if off of all seizure medication for at least three years. Regardless, all medical records must be submitted to the FAA [ [http://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/app_process/exam_tech/item46/amd/nc/ Aviation Medical Examiner ] ] .

Accidents caused by a seizure while driving

A study conducted by the National Center for Health Statistics found that fatalities caused by seizures that occurred while driving were relatively rare, resulting in less than 0.2% of all traffic-related fatalities in the years 1995-97 [ [http://www.neurology.org/cgi/content/abstract/63/6/1002?ck=nck Mortality in epilepsy: Driving fatalities vs other causes of death in patients with epilepsy - Sheth et al. 63 (6): 1002 - Neurology ] ] .

In March 2002, a Frederick, Maryland man was charged with vehicular manslaughter after a seizure he had while operating a motor vehicle resulted in an accident that killed 4 people [ [http://www.highbeam.com/doc/1P1-53142276.html Md. Driver Indicted in Deaths of Man, Sons; Epileptic Blamed Seizure for Crash | Article from The Washington Post | HighBeam Research ] ] . The man had been using a nerve stimulating device to treat his epileptic condition rather than seeking medical treatment [ [http://www.highbeam.com/doc/1P1-51699063.html Driver in Frederick Crash That Killed 4 Has Epilepsy; Man Tried to Treat Himself Before Accident, Authorities Say | Article from The Washington Post | HighBeam Research ] ] . He had been using this home remedy out of fear that if he had reported his condition to a physician, he would be stripped of his license.

External links

* [http://www.epilepsy.com/epilepsy/social_driving Epilepsy driving rights in the United States page 1] [http://www.epilepsy.com/epilepsy/rights_driving Epilepsy driving rights in the United States page 2]

References