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From Johns Hopkins University (Dr. Krauss and L. Ampaw) and the University of Maryland Medical Center (Dr. Krumholz), Baltimore.
Address correspondence and reprint requests to Dr. Krauss, Meyer 2-147, 600 North Wolfe Street, Baltimore, MD 21287; e-mail: gkrauss{at}jhmi.edu
Background:— States in the United States vary widely in their approaches to restricting driving for patients with epilepsy. Many states have shortened seizure-free restrictions or have adopted flexible regulations that consider individual clinical factors in determining driving privileges. The authors summarized state driving restrictions for patients with seizures, particularly unpublished regulatory practices, and determined the role and liability of physicians in judging driving safety for patients with epilepsy.
Methods:— The authors surveyed motor vehicle administration bureaus in the 50 states and the District of Columbia and compared the laws, regulations, and practices restricting driving for people with epilepsy. Key responses from a questionnaire were confirmed by state motor vehicle administrations with phone interviews and by a signed executive summary.
Results:— Twenty-eight states, including the District of Columbia, have laws requiring patients with epilepsy to be free of seizures for single fixed periods, with a median restriction of six months (range, 3 to 12 months). Twenty-three states have adopted more flexible approaches to restricting driving, such as varying seizure-free restrictions based on individual clinical factors. Many states allow patients to drive after shorter seizure-free periods than stated in their laws. These practices, however, are usually unpublished and not easily accessible. Physicians helped determine when their patients may drive in 13 states and were not legally shielded for their assessments in six of these states.
Conclusions:— States vary widely in how they regulate driving for patients with seizures. These varied regulatory approaches present potentially valuable models to determine how driving might be best regulated to protect public and patient safety optimally while permitting patients with controlled seizures to drive.
This article has been cited by other articles:
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  W. C. LaFrance Jr., A. S. Blum, I. W. Miller, C. E. Ryan, and G. I. Keitner Methodological Issues in Conducting Treatment Trials for Psychological Nonepileptic Seizures J Neuropsychiatry Clin Neurosci, November 1, 2007; 19(4): 391 - 398. [Abstract] [Full Text] [PDF]
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 J. W. Allen and O. Devinsky Treatment of physicians with epilepsy Neurology, September 25, 2007; 69(13): 1374 - 1379. [Abstract] [Full Text] [PDF]
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M. Sillanpaa and S. Shinnar Obtaining a driver's license and seizure relapse in patients with childhood-onset epilepsy Neurology, February 22, 2005; 64(4): 680 - 686. [Abstract] [Full Text] [PDF]
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S. G. Sheth, G. Krauss, A. Krumholz, and G. Li Mortality in epilepsy: Driving fatalities vs other causes of death in patients with epilepsy Neurology, September 28, 2004; 63(6): 1002 - 1007. [Abstract] [Full Text] [PDF]
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 A. Krumholz To Drive or Not to Drive: The 3-Month Seizure-Free Interval for People With Epilepsy Mayo Clin. Proc., July 1, 2003; 78(7): 817 - 818. [PDF]
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J. F. Drazkowski Management of the Social Consequences of Seizures Mayo Clin. Proc., May 1, 2003; 78(5): 641 - 649. [Abstract] [PDF]
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J. C. DeToledo, M. R. Lowe, D. Chadwick, and G. Krauss Driving restrictions and people with epilepsy Neurology, June 25, 2002; 58(12): 1864 - 1865. [Full Text] [PDF]
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 Driving Restrictions for People with Epilepsy Journal Watch (General), December 11, 2001; 2001(1211): 2 - 2. [Full Text]
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D. W. Chadwick Driving restrictions and people with epilepsy Neurology, November 27, 2001; 57(10): 1749 - 1749. [Full Text] [PDF]
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