OBJECTIVE: We identified clinical risk factors for seizure-related motor vehicle crashes in patients with epilepsy. BACKGROUND: Current US laws permit epilepsy patients with controlled seizures to drive. These laws attempt to balance the important economic and social value of driving with the risk to public safety from seizure-related crashes. Various clinical factors are considered in these laws, particularly the seizure-free interval. Driving restrictions range from 3 to 18 months, however, and studies have not established how these various seizure-free intervals and other clinical factors influence the risk for seizure-related motor vehicle crashes. METHODS: We performed a retrospective case-control study to determine the influence of clinical risk factors associated with seizure-related motor vehicle crashes. Both "case" and "control" patients had epilepsy, drove, and were from the same clinic, but the cases differed in having had seizure-related crashes. RESULTS: Fifty patients with epilepsy who crashed during seizures and 50 matched control patients were compared. Factors that significantly decreased the odds of patients with epilepsy having motor vehicle crashes due to seizures were: long seizure-free intervals, reliable auras, few prior nonseizure-related accidents, and having had their antiepileptic drugs (AEDs) reduced or switched. For example, patients who had seizure-free intervals > or = 12 months had a 93% reduced odds for crashing compared to patients with shorter intervals. Other findings were: 25% of patients had more than one seizure-related crash and 20% had missed an AED dose just prior to their crash. The majority (54%) of patients who crashed were driving illegally, with seizure-free intervals shorter than legally permitted. CONCLUSION: Seizure-free intervals, the presence of reliable auras, AED therapy modifications, and a history of nonseizure-induced crashes should be considered when counseling patients with epilepsy on driving and when formulating driving regulatory policy. Case control studies of crashes due to seizures can help in assessing and monitoring such risks.
OBJECTIVE: We identified clinical risk factors for seizure-related motor vehicle crashes in patients with epilepsy. BACKGROUND: Current US laws permit epilepsypatients with controlled seizures to drive. These laws attempt to balance the important economic and social value of driving with the risk to public safety from seizure-related crashes. Various clinical factors are considered in these laws, particularly the seizure-free interval. Driving restrictions range from 3 to 18 months, however, and studies have not established how these various seizure-free intervals and other clinical factors influence the risk for seizure-related motor vehicle crashes. METHODS: We performed a retrospective case-control study to determine the influence of clinical risk factors associated with seizure-related motor vehicle crashes. Both "case" and "control" patients had epilepsy, drove, and were from the same clinic, but the cases differed in having had seizure-related crashes. RESULTS: Fifty patients with epilepsy who crashed during seizures and 50 matched control patients were compared. Factors that significantly decreased the odds of patients with epilepsy having motor vehicle crashes due to seizures were: long seizure-free intervals, reliable auras, few prior nonseizure-related accidents, and having had their antiepileptic drugs (AEDs) reduced or switched. For example, patients who had seizure-free intervals > or = 12 months had a 93% reduced odds for crashing compared to patients with shorter intervals. Other findings were: 25% of patients had more than one seizure-related crash and 20% had missed an AED dose just prior to their crash. The majority (54%) of patients who crashed were driving illegally, with seizure-free intervals shorter than legally permitted. CONCLUSION:Seizure-free intervals, the presence of reliable auras, AED therapy modifications, and a history of nonseizure-induced crashes should be considered when counseling patients with epilepsy on driving and when formulating driving regulatory policy. Case control studies of crashes due to seizures can help in assessing and monitoring such risks.
Authors: Li Yang; Thomas B Morland; Kristen Schmits; Elizabeth Rawson; Poojitha Narasimhan; Joshua E Motelow; Michael J Purcaro; Kathy Peng; Saned Raouf; Matthew N Desalvo; Taemin Oh; Jerome Wilkerson; Jessica Bod; Aditya Srinivasan; Pimen Kurashvili; Joseph Anaya; Peter Manza; Nathan Danielson; Christopher B Ransom; Linda Huh; Susan Elrich; Jose Padin-Rosado; Yamini Naidu; Kamil Detyniecki; Hamada Hamid; Pue Farooque; Robert Astur; Bo Xiao; Robert B Duckrow; Hal Blumenfeld Journal: Epilepsy Behav Date: 2010-07 Impact factor: 2.937
Authors: Prince Antwi; Ece Atac; Jun Hwan Ryu; Christopher Andrew Arencibia; Shiori Tomatsu; Neehan Saleem; Jia Wu; Michael J Crowley; Barbara Banz; Federico E Vaca; Heinz Krestel; Hal Blumenfeld Journal: Epilepsy Behav Date: 2018-12-21 Impact factor: 2.937
Authors: Vineet Punia; Pue Farooque; William Chen; Lawrence J Hirsch; Anne T Berg; Hal Blumenfeld Journal: Epilepsia Date: 2015-09-22 Impact factor: 5.864
Authors: William C Chen; Eric Y Chen; Rahiwa Z Gebre; Michelle R Johnson; Ningcheng Li; Petr Vitkovskiy; Hal Blumenfeld Journal: Epilepsy Behav Date: 2014-01 Impact factor: 2.937