Driving and epilepsy

In the 10 years I have worked as an epilepsy nurse, some of the most uncomfortable discussions with patients like you have involved driving restrictions. The ability to obtain and hold a driver's license represents to many people in our society that they are grown up and have mastered the skills of independence. So when I start discussing the state laws on driving in regard to seizures, I feel as if I'm talking about punishment instead of feeling like a health care provider educating individuals about safety.

The truth is that these laws were written to prevent you from harming yourself or others while driving. Epilepsy is not the only condition for which state licensing agencies impose driving restrictions. People with progressive vision loss, for example, also may have their license suspended. The laws grant the privilege of driving to people who are the least likely to have an accident.

Every state regulates driver's license eligibility for individuals with epilepsy. The most common requirement is that you be seizure-free for a specified period of time. The period varies from state to state, ranging from 3 months to 2 years, so you need to know your own state's requirement. Your doctor must submit a statement concerning your ability to drive safely.

Another common requirement is the periodic submission of medical reports. Some states require a yearly report for 3 to 5 years, while others require that reports be submitted for as long as the person remains licensed. See the Epilepsy Foundation website for more details on your state's requirements.

You need to discuss the nature of your seizure disorder with your doctor to establish whether you can be licensed, perhaps with a restriction. Your doctor may base his or her recommendation on whether your seizures impair consciousness or movement, whether they occur only in your sleep, whether they are consistently preceded by an aura, whether they occur only at a certain time of day, or whether they occurred because you forgot to take your medication or because the doctor lowered your dose. Even if your doctor believes you can drive safely, however, the final decision lies with your state's licensing agency.

If you do not meet the requirements for a regular license, investigate the possibility of a restricted license. Many states allow individuals with seizures to hold a restricted license. This license permits driving under certain conditions, such as only during daytime, only to and from work within a certain distance from your home, or only during an emergency.

It's understandable for you to feel that you're being punished if your driving is restricted. Look up your state's laws and discuss with your doctor what restrictions are needed to maintain your safety in view of your individual seizure disorder. Remember that restrictions do not always last a lifetime; they may be temporary, just until your seizures are under good control.

If you have an unexpected seizure, don't hide it from your doctor in order to keep your driving privileges. Failure to report the seizure to your doctor not only endangers you and others on the highway, but also makes it impossible for your doctor to treat your epilepsy effectively. The doctor may be able to prevent more seizures from occurring by making a small change in the dosage of your seizure medicine, for instance, but that won't happen if the doctor doesn't know that it's necessary. It won't be so easy for you to hide the next seizure if it causes you or someone else to be injured.

If your seizures are not fully controlled and continue to impair consciousness or control of movement, you will need to develop alternative means of transportation. The use of public transportation, carpooling, van transportation, and even bicycle riding can be used to preserve your sense of independence while keeping you and others safe.

If your seizures are under good control, use your driving privileges as a motivation to take good care of yourself: take your seizure medicines as prescribed, get enough sleep, limit your alcohol consumption, and visit your doctor regularly.