Epilepsy and traffic safety.

We previously reported that drivers with epilepsy have somewhat higher age-adjusted rates of traffic accidents and moving violations than do drivers without epilepsy. We attempted to identify medical and other factors contributing to this increase. Medical records of 241 drivers with a history of seizures, representing essentially all such persons from a contiguous seven ZIP postal code area served by the Marshfield Clinic were studied. This zip code refers to a defined geographic area around Marshfield where virtually the entire population receives its care at the Marshfield Clinic and for which we have accurate records. Information abstracted from medical charts was used to identify potential risk factors for traffic accidents and violations among these drivers. Careless driving violations, alcohol or drug violations, and accidents (especially injury accidents) occurred at higher rates and speeding violations occurred at lower rates for drivers with epilepsy. Young age, unmarried state, history of multiple seizures, and lack of antiepileptic drug (AED) treatment appear to be risk factors for accidents among drivers who had a history of seizures. Male sex, psychiatric disorders, alcohol abuse, and generalized seizures or complex partial seizures (CPS) were also suggestively associated with higher risk. For moving violations, young age, male sex, unmarried state, symptomatic etiology, and history of alcohol abuse contributed to increased risk. We conclude that drivers with epilepsy appear to have identifiable risk factors for traffic mishaps, especially accidents.