Abstracts

General neurologists, and epileptologists, need to interpret and apply driving guidelines for patients with seizures and epilepsy. Physicians are expected to know and follow provincial regulations, which have variable reporting requirements. Our purpose was to determine clinicians[apos] familiarity with driver guideline restrictions, and the differences in application of restrictions between epileptologists and general neurologists., A modified motor vehicle driving questionnaire based on the Canadian Medical Association (CMA) Guidelines was mailed out to 33 neurologists in Calgary, Canada. The conditions listed were syncope with no obvious neurological or cardiac cause; aura or simple partial seizure unchanged for more than one year; unprovoked first seizure; epilepsy on treatment and seizure free; seizure during sleep or awakening with normal EEG; simple partial seizures (aura); seizure recurrence on medication withdrawal or change under medical direction; alcohol withdrawal seizures. The questionnaire asked to recommend duration of driving restrictions for various license classes (class 5= private car or small truck and 1-4= professional ). Auras and simple partial seizures were categorized separately but defined as non disabling sensory or motor seizures. Results are expressed as median and range. Groups are compared with the rank-sum test., 76% (25/33) of the questionnaires were returned. The responses were analyzed for the entire group and for epileptologist separately. For syncope, the entire group[apos]s responses were concordant with the CMA guidelines, but epileptologists recommended driving earlier (within 1 month) if the examination and investigations were normal. Neurologists and epileptologists agreed with CMA guidelines in patients with a solitary seizure and in those with only auras. However, both groups would restrict driving for 12 months, as opposed to the recommended 6 month. There is consensus for AED withdrawal seizures, alcohol related seizures. Interestingly, both groups would not restrict driving for an aura but would restrict driving for 12 months for [ldquo]simple partial seizures[rdquo]. More disagreement between neurologists and epileptologists occurred in restriction for commercial licenses, but these were not statistically significant., In an unprovoked first seizure general neurologists and epileptologists agree with guidelines[apos] restrictions, but in cases of syncope, epileptologists are less restrictive. Neurologists and epileptologists interpreted an aura to be different from a simple partial seizure. In general, neurologists and epileptologists are more restrictive for epilepsy than the recommended CMA guidelines. Differences between neurologists and epileptologists were not significant.,