Characteristics of Motor Vehicle Crashes Associated with Seizure: Car Crash Semiology

Neal A, et al. Neurology 2018;91:e1102-e1111.

Purpose

People with epilepsy are at an increased risk for car accidents related to their seizures. However, there is a lack of current data regarding the characteristics of seizure-related car accidents. This study examined patterns in seizure-related crashes, as well as how these patterns differed based on epilepsy or seizure type.

Description of Study

• The authors identified and compared seizure-related car crashes in people with epilepsy to car crashes that were unrelated to seizures between the years 2004 to 2017 in Victoria, Australia.
• 71 car crashes related to seizures involving 62 people with epilepsy were identified by cross-referencing 20,000 epileptologist medical records with the Victorian Police Traffic Incident and Road Crash Information System databases.
• 37 out of the 71 seizure-related crashes resulted in injury and could be identified and used for comparison.

Summary of Study Findings

• 70% of seizure-related crashes involved individuals who were considered “fit to drive.”
• 57% of seizure-related crashes involved a single vehicle, of which 95% were carrying a sole occupant.
• Most of the injuries resulting from seizure-related crashes were more severe than injuries resulting from non-seizure related crashes.
• Type of epilepsy also influenced crash patterns:
  • In general, drivers with generalized epilepsy were younger, more likely to have their epilepsy under control with medication, more likely to collide with a fixed object, more likely to have a crash earlier in the day, and more likely to experience seizure triggers as compared to drivers with focal epilepsy.
  • Accidents involving drivers with generalized epilepsy most commonly involved the vehicle going “out of control” before the collision. While those involving drivers with focal epilepsy most commonly involved the vehicle “going straight ahead” before the collision.

What does this mean?

• The findings of this study show that there are characteristic patterns associated with seizure-related car crashes involving people with epilepsy. These patterns vary according to seizure type.
• These results are useful to both people living with epilepsy and clinicians, suggesting several strategies for minimizing the risk of car crashes relating to seizures. Strategies involve education about seizure triggers and the possibility of driving with another passenger, as well as working with one’s physician to optimize morning anti-seizure medication levels.
• Collision characteristics can also be useful to policymakers to ensure that laws regarding seizures and driving are based on tangible scientific data.

Article published in Neurology, August 22, 2018.

Learn More

• Driving and Transportation
• State Driving Laws Database