Objective. To examine the frequency of driving an automobile and characteri
stics associated with driving in individuals with refractory localization-r
elated epilepsy. Background: Driving is generally restricted and monitored
in people with epilepsy. Little is known about the frequency of driving and
subsequent accidents specifically in individuals with uncontrolled epileps
y. Methods: In an ongoing, prospective, multicenter study of resective epil
epsy surgery, individuals were interviewed when they presented for surgical
evaluation. Analyses were conducted using chi-square, t-tests, and multipl
e logistic regression. Results: Of 367 eligible participants, 115 (31.3%) h
ad driven in the last year, most on at least a weekly basis. In a multivari
able analysis, factors associated with an increased likelihood of driving w
ere having a current license (OR = 10.71, p < 0.001) and ever having had a
license (OR = 3.86, p = 0.003). Younger individuals were also more likely t
o drive. Lower levels of driving were found in women (OR = 0.31, p < 0.001)
, individuals who were self-described as disabled (OR = 0.20, p < 0.001),an
d those who were employed full-time (OR = 0.43, p = 0.03) or part-time (OR
= 0.15, p = 0.005). At some point in the past, 144 individuals experienced
one or more seizures: while driving, and 98 experienced at least one accide
nt because of a seizure. Of those who had accidents, 94% reported property
damage, 32% had an injury, and 20% cause injury to others. Conclusions: Des
pite restrictions, almost one third of individuals with refractory epilepsy
drive. Understanding why they do may help identify means of modifying this
behavior or identifying services that, if provided, would help people:with
uncontrolled epilepsy forego driving.