On the Road Responsibly: Driving With Epilepsy

By Regina Reid
EpilepsyUSA staff
Posted: March 21, 2003

Every teenager nearing driving age probably hears it from their parents: driving is a privilege, not a right. But it is a privilege not many adults anticipate being denied.

Still, there are many instances where people with epilepsy have had to give up the convenience of driving in favor of safety -- their own as well as that of the other people on the road.

Not a Major Public Safety Problem, but Cause for Concern

Accidents involving drivers with seizures are often given sensationalized coverage by the media, even though drivers with epilepsy are rarely involved in the 44,000 car-related deaths recorded each year. People with epilepsy are at a slightly higher risk for accidents than the general driving public. However, heart conditions and hypertension (high blood pressure) are the most common medical conditions related to vehicular fatalities.

Gregory Krauss, M.D., assistant professor of neurology at Johns Hopkins Hospital in Baltimore, Md., co-authored a study which reported that "there is not a major public safety issue with patients with epilepsy driving, in that the numbers of crashes are fairly small compared with other conditions."

Krauss cautions, though, that "patients shouldn't drive until their seizures are controlled since it is potentially a preventable problem."

Mark Spitz, M.D., director of the Comprehensive Epilepsy Center and professor of neurology at the University of Colorado Health Sciences Center, agrees.

"There are people out there driving who are not under control," he said. "It's like somebody drinking and driving."

Depending on where people live, the law may require a doctor to report seizures and epilepsy to the motor vehicle administration. But many states operate on the honor system, which means it's up to each person to disclose the condition when applying for a license.

Risks Well-Illustrated

Spitz said two-thirds of people with epilepsy are safe on the road as long as their seizures are well controlled and they are taking their medication. However, the dangers of driving with uncontrolled seizures are well documented. Over the past year, cases from Wisconsin, Maryland and Colorado have gained national attention. All involved a person having a seizure while driving, resulting in the serious injury or death of someone else on the road.

Doctors Not in Favor of Stricter Laws

Lawmakers in some states, including those where high-profile accidents occurred, are considering legislation that would change the laws regarding drivers with medical conditions. But doctors fear that tighter restrictions might discourage their patients from being honest about their seizures.

"One thing that would reduce your risk of crashing is to optimize your treatment," Krauss said, "and we're afraid if people aren't frank with us about their seizures, maybe that won't happen."

The Epilepsy Foundation favors individualized evaluations of a person's ability to drive, based on type and frequency of seizures, whether or not there is a warning, the time of day seizures generally occur (e.g. during sleep, upon waking), the person's willingness to take prescribed medication regularly and any side effects of medication.

The Foundation also warns people not to drive if they've been having seizures or are missing their medication.

Driving is not something that people who have seizures can take for granted. Regular consultation with the doctor and individual sound judgment are the best tools to employ when deciding whether or not to get, or stay, behind the wheel.

For more information about epilepsy and driving, check out the Answer Place.