Abstracts

Rationale: People with epileptic seizures (ES) are specifically restricted from operating a motor vehicle for varying lengths of time by applicable laws. Those who experience "seizure-like" non-epileptic events (NEE) may be counseled to follow the same driving restrictions, but no specific driving laws are targeted to people with NEE so it is left up to the physician's discretion. A survey conducted in 2000 showed that close to half of responding physicians faced by this decision chose to apply the same driving restrictions to people with NEE and people with ES¹. Data supporting the need for such restrictions is lacking. Other medical conditions are associated with a higher crash risk, but people with those conditions are not specifically restricted from driving². The purpose of this study is to characterize the driving habits of people with NEE, their compliance with driving restrictions, the incidence of NEE while driving and the incidence of motor vehicle accidents (MVAs) due to those events. Methods: Patients admitted to the Epilepsy Monitoring Unit (EMU) at Mayo Clinic Arizona between November 2012 and December 2013 for event classification were asked to complete a survey upon admission to determine if they had ever suffered an event (ES or NEE) while driving. Other questions addressed driving history, prior counseling on driving, frequency of events, and the nature and severity of any crashes that resulted from such events. Patient charts were later reviewed to obtain final diagnoses and other demographic information. Results: A total of 56 surveys were completed by patients with the following diagnoses: 27 (48%) NEE, 17 (30%) indeterminate, 6 (11%) alternative organic diagnosis, 4 (7%) epilepsy and 2 (3.5%) a combination of epilepsy and NEE. 21 out of 27 people (78%) diagnosed with NEE had been told that they should not be driving prior to admission. Of those that were advised not to drive, 14 out of 21 (67%) were compliant with that recommendation. Ten of 27 patients (37%) diagnosed with NEE reported typical events occurring while driving, with only one leading to a minor MVA. For the other patients, 2 of 4 diagnosed with epilepsy (50%) reported typical events occurring while driving (both led to MVAs), 4 out of 17 with indeterminate diagnoses (12%, no MVAs), and 4 of 6 with alternative organic diagnoses (67%, 1 led to MVA). Conclusions: Based on data collected so far, people with NEE may experience their events while driving, but these are less likely to lead to a crash than ES and other organic symptoms, suggesting that similar driving restrictions are not necessary. Current study enrollment limited statistical comparisons between subjects with NEE and ES. Further data collection and statistical analyses will be helpful to guide clinicians regarding the necessity of driving restrictions for people with NEE. References 1. Benbadis, SR, JN Blustein, and L Sunstad. 2000. Should patients with psychogenic nonepileptic seizures be allowed to drive? Epilepsia 41(7):895-897. 2. Drazkowski, JF and JI Sirven. 2011. Driving and neurologic disorders. Neurology 76 (7):S44-S49