A driver's license is a passport to adulthood in the United States and many other countries. In both rural and suburban areas, access to a motor vehicle is often essential for independence and employment. Even in many urban areas, driving is required for a some jobs or to reach certain locations for work or pleasure.
Driving and Epilepsy — Epilepsy Foundation of Northern California
An interview with Dr. Robert Fisher on driving and epilepsy, recorded while driving.
Driving is a privilege, and applicants must meet the criteria set forth by their state to qualify for a driver's license. Applicants in all states must be older than a minimum age (usually 16 or 17 years), must not have a medical disorder that would make driving dangerous, and must pass a written test, a vision test, and a driving test.
The laws determining which medical conditions disqualify someone from obtaining a driver's license vary from state to state. In many states, the laws have become more liberal in recent years, resulting in fewer restrictions for people with epilepsy. Information on laws in each state can be found at the Epilepsy Foundation website.
The laws are written to protect public safety and to grant the privilege of driving to people who are the least likely to have an accident. Compared with those of most European nations, however, driving restrictions in the United States are quite liberal. In some European countries, for example, a single tonic-clonic seizure in adulthood prohibits holding a license for the rest of the person's life.
Many people do not recognize that absence or complex partial seizures while driving can be just as deadly as tonic-clonic seizures. Furthermore, the risk of injury or death is not restricted to the driver and passengers but applies to pedestrians and people in other vehicles. Studies have shown that the rate of motor vehicle accidents for people with epilepsy is higher than the average rate, but nowhere near the rate for those who drink and drive. In some cases, accidents involving epilepsy are caused by people, especially men, who are driving without a license or who fail to report their epilepsy when applying for a license.
To obtain a driver's license in most U.S. states, a person with epilepsy must be free of seizures that affect consciousness for a certain period of time. The seizure-free period varies from state to state. The recent trend is away from requiring an "absolute period" of being seizure-free toward a shorter interval of freedom from seizures. Although some states still require a period of at least 1 year during which the person with epilepsy is seizure-free, most consider exceptions that would permit someone to drive after a shorter seizure-free interval.
A recent conference of professional and lay epilepsy organizations recommended a seizure-free period of 3 months for driving privileges. In some states, the doctor who cares for the person with epilepsy must fill out a form stating that it is safe for the person to drive and recommending licensure. This recommendation is used as one of several factors in making a decision. In states that do not require a specific seizure-free period, the doctor's recommendation often carries considerable weight.
In most states, the medical information submitted by the applicant and the doctor is reviewed by personnel in the state's department of motor vehicles (or equivalent department). In complex cases, or those in which the decision is uncertain, the information is usually forwarded to a consulting doctor or the state's medical advisory board. Most states have such a board, which may also hear appeals concerning decisions to deny or revoke drivers' licenses. Decisions made by the motor vehicle department can be appealed by requesting an administrative hearing before the medical advisory board or another designated body. If the administrative decision is not favorable, the applicant can request a review by a judge. Such requests must be made within a specified period.
In some states, someone with persistent seizures may be allowed to drive if the seizures do not impair consciousness or control of movement, occur only during sleep, are consistently preceded by an aura, are restricted to a certain time of the day (such as within an hour after awakening), or occur only when the seizure medicines have been reduced or stopped on the advice of a doctor. A letter from the doctor confirming the presence and consistency of these features is often required by the state motor vehicle agency. If a driver's license is revoked because of a breakthrough seizure surrounded by extenuating circumstances (reduction of medication on a doctor's advice or unusual stress such as the death of a loved one, for instance) the driver may appeal the decision, as described earlier. Evidence that the person takes the prescribed medications is often required, and the level of the seizure medicine in the blood is usually provided as confirmation of compliance.
In some states, people who do not meet the requirements for a regular driver's license may be granted a restricted license. This license may allow a person with epilepsy or other disabilities to drive under certain conditions, such as during daytime only, to and from work within a certain distance from the home, or only during an emergency.
The US Department of Transportation (DOT) has prohibited anyone with a history of epilepsy from driving a truck between states. These regulations have been under review, however, so a person with epilepsy who is interested in driving a truck should contact the DOT for up-to-date regulations.
The blanket denial of a commercial driver's license to any person with a history of epilepsy is unfair for several reasons. Some childhood epilepsies, such as benign rolandic epilepsy, are associated with a high remission rate; the seizures in some persons may have been fully controlled for years; and some types of seizures are not dangerous if they occur while driving.
Regulations for driving a truck or bus within one state vary from state to state. Some states have restrictive policies that prohibit any person with a history of epilepsy from driving a commercial vehicle. Others take the more reasonable approach and review each case individually.
Some states that grant driver's licenses to people with epilepsy require periodic medical reports. These reports document that seizure control has not deteriorated and that the person is taking or does not need to take medications. If the seizures have stopped or have been controlled for more than 3 to 5 years, most states will no longer require periodic medical reports.
Regardless of the reporting requirements, if seizures recur and impair consciousness or control of movement, it is imperative to stop driving and consult the doctor, who may be able to suggest changes in lifestyle (such as more sleep) or adjustments in medications that may restore seizure control.
A person with epilepsy may be civilly or criminally liable for a motor vehicle accident caused by seizures. Liability may occur when a person drives against medical advice, without a valid license, without notifying the state department of motor vehicles of the medical condition, or with the knowledge that he or she is prohibited from driving.
In 2001, six states (California, Delaware, Nevada, New Jersey, Oregon, and Pennsylvania) had "mandatory reporting laws" requiring that doctors report persons with epilepsy and other disorders that may make driving hazardous. These laws generally order the doctor to notify the department of motor vehicles of the person's name, age, and address. In these states, doctors may be liable for negligence if they fail to report a person with epilepsy who is later involved in a motor vehicle accident. In states without such laws, however, the question of whether a doctor should report a patient who may be driving unsafely presents a difficult conflict between public safety and the doctor's need to respect the privacy of the relationship with the patient. In theory, a physician who reports a patient's condition could be sued for disclosing confidential information. As discussed later, the state of Connecticut has attempted to establish a middle ground in this conflict.
In states that do have mandatory reporting laws, the specifics of when a doctor must report someone can be vague. In New Jersey, for example, the law states that the doctor will report any person 16 years of age or older for recurrent convulsive seizures or for recurrent periods of unconsciousness or for impairment or loss of motor coordination due to conditions such as, but not limited to, epilepsy in any of its forms when such conditions persist or recur despite medical treatments. This law is open to some interpretation. For example, it remains unclear what constitutes "medical treatments." The plural usage indicates that more than one treatment has failed to control the seizures but does not specify how many dosage adjustments or medications must have been tried.
Mandatory reporting laws should be repealed, as was done by Connecticut in 1990. However, if a physician in Connecticut cares for a person whose seizures are so poorly controlled that driving would present a serious risk to public safety, and there is evidence that the person continues to drive, the doctor can report the person with immunity from lawsuit by the patient. Such cases are rare. Connecticut's approach to mandatory reporting is a reasonable middle ground, as it strikes a balance between the rights of the individual and the public's safety.
The chief problem with mandatory reporting is that it can destroy the doctor-patient relationship. In many cases, those who believe that they "must" drive will lie to the doctor about their condition in order to avoid mandatory reporting and potential loss of the driver's license. This is the worst of both worlds: the person is not receiving the best medical care and is driving. If the doctor and patient can work together, the seizures are likely to be better controlled, and the person can drive more safely.
The most common penalty for a physician's failure to report a patient under mandatory reporting laws is a fine, usually ranging from $5 to $50. However, an accident can lead to a lawsuit charging wrongful death or injury, with a large judgment against the doctor. In states that require mandatory reporting, compliance varies widely among doctors.
Doctors who state that it is safe for a person with epilepsy to drive and recommend licensure could also face some liability in case of an accident, although it appears to be minimal. Very few cases have been brought against a doctor by a third party who was injured in a motor vehicle accident allegedly caused by a person with epilepsy. Doctors should not be liable for recommendations made to the department of motor vehicles if their opinions are reasonable and consistent with good medical care. Some states grant immunity from liability to doctors who make recommendations about driving privileges.
Topic Editor: James W. Wheless, M.D. Last Reviewed:3/22/04
|Faked seizures||Oct 3, 2009|
|I Have Epilepsy and I Hate My Life...||Aug 17, 2009|
|Food-Triggered Siezures||Sep 25, 2009|
|Temporal lobe surgery||Aug 16, 2009|
|Can exercise induce seizures?||Sep 11, 2009|
|terrified to get pregnant||Sep 19, 2009|
|Epilepsy triggers?||Aug 9, 2009|
|The Reasons not to consume alcohol or smoke marijuana if you have epilepsy||Jul 30, 2009|
|Seizure While Driving||Jul 29, 2009|
|Do seizures change characteristics over time?||Jul 25, 2009|
|View all Forums|
|Grand Mal a week ago - Still feeling dizzy||Dec 21, 2013|
|Seizures return after 30 years?!||Dec 21, 2013|
|My Husband has Narcoleptic Grandmal Seizures and wants a BABY!!||Dec 21, 2013|
|I'm scared, Dilantin is killing me!||Dec 20, 2013|
|Simple partial seizures left untreated||Dec 20, 2013|
|Being a Nurse who has epilepsy||Dec 20, 2013|
|Has anyone else had a feeling of complete overstimulation?||Dec 20, 2013|
|Need some insight regarding symptoms I feel are possibly seizure related||Dec 20, 2013|
|Hi, I'm Caeti! New to having seizures...I think...?||Dec 20, 2013|
|Memory Loss/Side Effects - Lamictal vs. Topomax||Dec 20, 2013|
|View all Forums|
|topamax and weight loss||19,412|
|Possible cure for absence seizures||16,695|
|How exactly do aura's feel||14,771|
|Sexual Side Effects||13,634|
|MEDICAL ALERT I.D.'s||12,607|
|Over 40 Different Types Of Seizures - Revised||10,553|
|electrical shock in head?||10,131|
|Weight Gain and Depakote||9,035|
|View all Forums|
|This Isn't Ebay Folks!!!!!!!!!||Aug 7, 2009|
|Drum Roll.....||Jul 27, 2009|
|Well he has arrived!||Sep 28, 2009|
|BEEN A LONG.........PROBABLY A LONG PURGING BLOG COMING........I'M BEING FOLLOWED BY A MOONSHADOW....||Aug 8, 2009|
|A Year Since Surgery||Aug 17, 2009|
|Ohhhhh Baby!||Sep 5, 2009|
|Find insurance for Epilepsy||Oct 27, 2009|
|AS THE DRUG COMPANY TURNS - THE SOAP OPERA||Aug 1, 2009|
|Changing seizures..very scary||Jul 29, 2009|
|Quitting medication after brain operation||Aug 7, 2009|
|View all Blogs|
|Falling Down Funny - It's Harder On Us Than It Is On You||Dec 21, 2013|
|keppra and depakote together?||Dec 20, 2013|
|Overwhelmed||Dec 20, 2013|
|Hyperventilation & epilepsy, a way to help yourself.||Dec 17, 2013|
|Brain Zaps, tics & twitches||Dec 15, 2013|
|Why?!||Dec 15, 2013|
|halfway there!||Dec 13, 2013|
|withdrawal symptoms||Dec 13, 2013|
|women classic snow boots all can get 60% off||Dec 12, 2013|
|update seizure first aid||Dec 12, 2013|
|View all Blogs|
|my partial complex seizures||4,606|
|Topomax... The Dreaded.........||3,805|
|How can you tell if a sleep seizure happens?||3,602|
|Brain Zaps, tics & twitches||3,600|
|side effects of phenobarb.||3,226|
|Tegretol XR and ANXIETY meds||2,907|
|TYLENOL, AEDs & SEIZURES||2,844|
|Nonepileptic "Events" vs. "Seizures"||2,721|
|View all Blogs|
|support group for individuals w/ epilepsy||Oct 18, 2009|
|Epilepsy and Movies||Sep 10, 2009|
|Epilepsy and Memory Loss??||Sep 17, 2009|
|EPILEPSY SUPPORT GROUP NORTH CAROLINA||Oct 12, 2009|
|View all Groups|
|Cheap Canada Goose Jackets Outlet on sale 60% off online||Dec 12, 2013|
|epilepsy only||Dec 11, 2013|
|Hawaiian and have epilepsy||Nov 28, 2013|
|Epileptics over 50 with poorly controlled seizures||Oct 28, 2013|
|The "CHillin Out" Chat group||Oct 14, 2013|
|Epilepsy Marathon||Oct 13, 2013|
|Epilepsy and Hormones||Oct 5, 2013|
|Epileptics Working from Home for Websites||Sep 18, 2013|
|new worried Mum||Jul 24, 2013|
|Types of Epilepsy||Jul 23, 2013|
|View all Groups|
|Parents Of Children With Epilepsy||269|
|Temporal Lobe Epilepsy||171|
|Women and epilepsy||170|
|Living a life with Epilepsy||133|
|Anyone with Simple Partial Seizures||109|
|Dating and Epilepsy||94|
|Epilepsy and Memory Loss??||88|
|Epilepsy Surgery Group||74|
|Absence Seizures in Kids||73|
|View all Groups|
|36 years epilepsy and seizure free so far after op.||Jul 26, 2009|
|Isolated Seizures, Don't feel the need for Meds...||Aug 31, 2009|
|giving humans another try ;)||Oct 27, 2009|
|growning up||Oct 21, 2009|
|Epilepsy and other goodies||Jul 27, 2009|
|Absent Memories||Oct 29, 2009|
|Journey of Epilepsy||Aug 6, 2009|
|Silent Traumatic Epilepsy as a result of a subarachnoid hemorrhage||Aug 7, 2009|
|Epilepsy and my daughter||Aug 12, 2009|
|Temporal lobe epilepsy||Aug 19, 2009|
|View all Stories|
|Side effects after right selective amygdalahippocampectomy||Dec 20, 2013|
|Seizures return after 30 year absence?!||Dec 20, 2013|
|Newly diagnosed at age 56||Dec 19, 2013|
|My son`s future||Dec 19, 2013|
|AN Amazing Testimony On A Spell Caster Who help me to get pregnant||Dec 18, 2013|
|Suddenly I'm having seizures after many years with no problem||Dec 17, 2013|
|seizure free for 2 months||Dec 16, 2013|
|My story||Dec 16, 2013|
|my story||Dec 15, 2013|
|epilepsy||Dec 14, 2013|
|View all Stories|
|Temporal Lobe Epilepsy||657|
|Always Have On Clean Underwear||533|
|my brain has died a thousand deaths...........||532|
|Kelly's Life With Epilepsy||496|
|What My Seizures Are Like......||434|
|Nocturnal grand mal seizures (primary generalized epilepsy)||431|
|My Daily Philosophy.....||386|
|View all Stories|