Abstracts

Rationale: People with epilepsy often have impaired consciousness during seizures and lose the ability to interact with their surroundings. Since driving is an essential part of daily life, it is particularly important to understand how impaired consciousness in epilepsy affects driving abilities. However, the transient nature of seizures and lack of standardized easy-to-use behavioral testing methods have limited previous work on this subject. Prior work using computer-based driving simulators and external controllers (e.g. steering wheel, brake and gas pedals) was cumbersome in the video/EEG monitoring unit, motivating the development of a portable handheld device to evaluate driving more easily. Methods: We have chosen tablets as our new behavioral testing instruments because they have the distinct advantages of being lightweight, easy-to-pick-up, and behaviorally absorbing. We used a commercially available driving game with customization on the tablets to evaluate ictal and interictal driving performance prospectively. In order to capture specific driving metrics including car position, car velocity, acceleration/braking, steering wheel movement, and collision events, we developed specialized apps which utilize the devices' built-in sensors on the tablet platform, and recorded driving performance continuously on the same time base as clinical video/EEG recordings. Results: We enrolled 12 patients who drove an average of 248.8±79.8 minutes (MEAN±SEM, N=12, range 18-969 minutes) each during video/EEG monitoring. Preliminary testing showed the feasibility of using a handheld device for examining driving performance in epileptic patients prospectively. Patients and staff reported good tolerability and greater convenience than with the larger computer and peripheral-based devices. Data analyses were capable of reconstructing all driving parameters including car position, velocity, steering wheel position, and collisions, simultaneous with video/EEG results. Conclusions: With ongoing data collection and analysis, we hope to understand the relationship between driving risk in the ictal/interictal periods and specific seizure-related variables such as seizure duration, type, and localization. Our ultimate objective is to provide more informed advice regarding driving safety to legislators, physicians, and patients with epilepsy.