Driving with epilepsy: when to start?

One of the big ways in which epilepsy and seizures negatively affect quality of life is by the restrictions they impose on driving. So should patients with epilepsy be allowed to drive and if so when? Is it safe from them to drive?

All these are genuine questions for which patients frequently seek answers. Well lets tackle them one by one. Normally if you have a new onset seizure (your first seizure ever) and present to the hospital, your doctor shall ask you not to drive at least till the seizure work up is complete. The seizure workup shall determine what is the cause of your seizure, do you need to be on a seizure medication, if yes for how long and what are the chances that you are going to have another seizure.

If the cause of seizure is found to be reversible, lets say for example you are diabetic and have a seizure when your blood sugar suddenly fell down as you took your insulin shot but missed a meal. Now this is a reversible cause of seizure and the patient does not have epilepsy. If his blood sugar does not fall down again, he may never have a second seizure. In this case the answer is simple and yes the patient can drive.

Lets take another example, a patient has poorly controlled epilepsy and is brought to the hospital after a seizure at work. In this case, the doctor shall rightly advise the patient not to drive. A patient like this is liable to have another seizure and may injure himself or hurt others if he is behind the wheel.

But this does not mean, that a patient with epilepsy can never drive. If your seizures have been well controlled on medication for a period of 2 years, you may discuss driving again with your doctor. Drving laws with respect to epilepsy vary from state to state in USA. In the state of New York, as a physician I am not mandated by law to report my patient with epilepsy to the DMV. It is left to the patient’s own good judgement that he or she shall surrender their driving license and not drive. In the state of New Jersy though, physicians are mandated by law to report seizure patients to the DMV.

You should be aware of the laws in your state and should discuss the same with your doctor. Most of the bylaws can be found on the DMV website and are listed for each state.

I hope you found this information useful. Its wednesday night and the clock strikes 10pm. I think my bed is calling. Have a good night everyone.

Personal Regards,

Nitin Sethi, MD

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