Abstracts

RATIONALE: In the United States, individual states determine the rules for driving with epilepsy. Many states have adopted flexible, often unpublished, driving restrictions for patients with epilepsy, allowing motor vehicle boards or treating physicians to consider clinical factors in determining when patients with epilepsy may drive. In order to highlight the diversity of state approaches for limiting driving, we surveyed published and unpublished state practices restricting driving for patients with epilepsy. METHODS: We queried the motor vehicle administration bureaus (MVA) of the 51 U.S. states and D.C. about their seizure driving restrictions using a written questionnaire. We then had states confirm a written summary of these practices. We queried states about unusual or unique restrictions on driving for patients with epilepsy by phone interview. RESULTS: Thirty states, including the District of Columbia, have laws requiring drivers with epilepsy to be free of seizures for single fixed periods, ranging from 3 to 12 months (median 6 months). Twenty-one states have adopted more flexible approaches to restricting driving for patients with epilepsy. These approaches range from initially limiting driving (e.g. to local areas at slow speeds), to restricting patients from driving for a range of periods according to seizure severity, to no set restrictions with restrictions set by the MVA or treating physicians. Most states ask treating physicians to judge whether their patients with seizures may drive safely; physicians are legally liable for these judgements in 16 states. Nineteen states liberalized their restrictions on driving for patients with epilepsy between 1988 and 2000. CONCLUSIONS: There is tremendous diversity and flux in the state restrictions on driving for patients with epilepsy. Many of these rules need to be better documented and publicized. These varying approaches provide interesting models for how driving might best be restricted following seizures so to protect public safety while permitting patients with controlled seizures to drive. Financial assistance was provided by the Epilepsy Foundation of the Chesapeake Region.