Abstracts

Rationale: Driving is important to patients with epilepsy (PWE) and allows for optimal quality of life. Driving is prohibited when PWE are not seizure free as motor vehicle accidents (MVAs) may result from breakthrough seizures due to drivers with epilepsy (DWE). Despite state driving restrictions for PWE, many continue to drive. We sought to characterize DWE that intend to be disobedient with driving laws. Methods: A 12-question survey was delivered to 287 consecutive PWE at a single outpatient epilepsy clinic in Florida. Participation was voluntary and surveys were completed around the time of clinical visitation and evaluated at study completion. 236 surveys were evaluated (age and gender included) and 51 were not due to incomplete information or alternate primary diagnosis. Following informed consent, PWE were prospectively surveyed between 11/08 and 2/09. Responses were retrospectively reviewed for disobedient DWE that negatively responded to the question; Do you plan to wait the entire length of time before you are informed that it is okay to resume driving? . All questions were multiple choice questions or yes-no responses. The survey format included information on demographics, driving, last seizure, number of lifetime seizures, AEDs, emotional reaction to restriction, and awareness of the driving restrictions for PWE. Results: 182/236 (77.1%) PWE (144 F) responded yes and would wait before driving but 27 (11.4%) said no , 15 (6.4%) did not respond, 9 (3.8%) responded NA (1 checked both, 1 responded ? , and 1 wrote seizure free ). The disobedient 27 DWE (16 F) were aged 49.9 years (range 21-80 y), were primarily Caucasian (n=21), with epilepsy in 24/27 cases (3 reported 1 seizure). 14/27 (51.9%) had >20 seizures in their lifetime. The last seizure was < 6 months in 23/27 (85.1%). 20/27 (74.0%) did not comply, 16/27 (59.3%) drove wherever they needed to go but only 4/27 self-reported non-compliance with AEDs (p=0.006). Most patients (16/27) took a single drug, 8 were on 2, 1 was on 4 AEDs, 1 had VNS (1 not taking AEDs). 24 held valid licenses (22 from FL), and nearly 2/3rds (17/27=63.0%) knew the restriction. 26/27 PWE had a negative reaction to restriction (3 with > 1 reaction), and only 1 felt relieved when told (p=<0.0001). 8/27 (29.6 %) denied having the law discussed with them despite written attestation in all. Informed DWE 16/19 (84.2%) knew the law in contrast to 1/8 (12.5%) uninformed DWE (p=0.12). In contrast to sadness which was reported in the group as a whole (75/236), anger (8/27) was the most common initial impulse to restriction in disobedient DWE. Only 7/27 (25.9%) had an initial impulse to wait v 198/236 (83.9%) of the group (p=0.006).