EPILEPSY AND DRIVING - AN INTERNATIONAL PERSPECTIVE

Individuals with a history of seizures may be granted driving privileg es if the risks of future seizure while driving are relatively low. Di fferent nations have defined these risks in a wide variety of ways. So me countries, e.g., Japan, Greece, Brazil, India, and Russia, preclude driving after a single seizure. Other countries, such as Canada and t he United States, allow driving less than or equal to 3 months after c ertain types of seizures. A Joint Commission of the International Bure au for Epilepsy/International League Against Epilepsy has summarized r egulations in several countries. From a consideration of medical liter ature and existing practices, a series of proposed guidelines for driv ing and epilepsy is recommended. In general, these guidelines suggest use of a seizure-free interval, generally 1-2 years but less in partic ular instances, to determine fitness to drive. Required physician repo rting is discouraged, but physicians should report patients whom they believe pose a danger to themselves and to public safety. Individualiz ed consideration should be given to special circumstances that may mod ify a general driving prohibition. Education and information programs are necessary for medical and regulatory authorities to develop a rati onal approach to driving and epilepsy worldwide.