Abstracts

Rationale: Several factors increase the risk of epilepsy-related injuries including motor vehicle accidents (MVA), such as seizure frequency, lack of a prolonged seizure-free interval, and use of multiple anti-epileptic drugs.¹ Most countries have a safety law that prevents patients with epilepsy from driving unless they complete a certain seizure-free period after discontinuing medications and that has led to a reduction in the number and severity of epilepsy related MVAs. MVAs are the leading cause of death of young males in the United Arab Emirates. The country has been putting an effort in trying to reduce the number of MVAs. The country has no restrictions on issuing driving licenses to patients with epilepsy. There is only one study to date published in 1996 that looked at the effects of epilepsy on driving in UAE, it showed that there is an increase in MVAs among patients with epilepsy.² The aim of our study is to determine how Neurologists across the UAE feel about driving and epilepsy, and to recommend a driving restriction for patients with epilepsy to the local authorities if supported by our study. Methods: A survey made of 7 questions was sent out to practicing neurologists in the country (74 in total), and 54 responded.It included questions on whether neurologists think that they should report every seizure or report patients with epilepsy to the local authorities, and whether they would allow them to drive after a certain seizure free period, and if they do, then how long a seizure free period would they recommend. Results: 54 neurologists responded. Most of them (87%) did not feel that they should report all first seizure cases to the DMV, however for patients confirmed to have epilepsy 50% felt that that they had to report. Those surveyed were equally divided in regards to when a patient should be allowed to drive after a seizure (6 months 46.3% vs 12 months 46.3%), and only 5.6% would allow their patients to drive 3 months after a seizure. 59.36% would allow a patient to drive if risk of recurrence is less than 25%. 53.85% would allow a patient to drive if they were seizure free for 6 months after medication withdrawal. Most would allow a patient with only nocturnal seizures to drive. Conclusions: Most of the neurologists in the country share our concerns that there must be legislation regarding driving for patients with epilepsy. We propose a 6 month restriction on driving and operating heavy machinery for patients who had a first seizure. Physicians do not have to report the patient unless they know that the patient is driving a vehicle. Patients with a single seizure that is unlikely to recur can begin driving once their workup is complete, and those with epilepsy can begin driving 6 months after medications have been withdrawn and they continue to be seizure free. Those patients who have had only nocturnal seizures for one year, would be allowed to drive. Patients who have seizures with clear distinct auras should not be allowed to drive unless seizure free for 6 months. 1. Epilepsia, 2006, 47(1), pp.79-86 2. Seizure - European Journal of Epilepsy, 1996 5(3), pp.215-219