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Epilepsy and motor vehicle driving - A Symposium held in Québec City, November 1998

Published online by Cambridge University Press:  02 December 2014

Guy-M. Rémillard ,
Benjamin G. Zifkin  and
Frederick Andermann
Guy-M. Rémillard
Affiliation:
Epilepsy Clinic, Montréal Neurological Hospital, Neurology Service, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada
Benjamin G. Zifkin
Affiliation:
Epilepsy Clinic, Montréal Neurological Hospital, Neurology Service, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada
Frederick Andermann
Affiliation:
Montréal Neurological Institute and Hospital, Faculty of Medicine, McGill University, Montréal, Québec, Canada
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Abstract

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Background:

This report summarizes an invitational symposium on epilepsy and Canadian laws governing motor vehicle driving held in Québec City in November 1998.

Methods:

Invited neurological experts from Canada, the USA, and Europe; and representatives of provincial and territorial licensing bodies, the Canadian Council of Motor Transport Administrators, the Canadian Medical Protective Association, and the Canadian Medical Association participated. An edited version of transcribed audiotapes was prepared. Specific issues discussed were whether or not a physician should be required to report a patient with epilepsy to the licensing authority (mandatory reporting), the nature and quantification of the risks posed by epileptic drivers, and what would be a reasonable law regulating driving by people with epilepsy in Canada.

Results:

The consensus among medical experts was that mandatory reporting should be abolished in Canada and that a 6-12 month seizure-free period was appropriate before most patients could return to driving private cars. Experts also believed that these standards should be uniform across Canada. There was strong disagreement with the recommendation of the Canadian Medical Association that all such drivers be reported to provincial licensing authorities even in provinces without mandatory reporting rules.

Conclusion:

Physicians should be familiar with and follow the rules regarding epilepsy and driving in the provinces where they practice. Nevertheless, current evidence is against mandatory physician reporting of drivers with epilepsy and the neurologists recommended that this be abolished throughout Canada. Shorter seizure-free intervals should also be considered before resuming driving of private cars.

Résumé:

RÉSUMÉ:Introduction:

Ce rapport constitue le sommaire d’un symposium sur invitation, portant sur ’épilepsie et les lois Canadiennes concernant la conduite de véhicules motorisés, tenu à Québec en novembre 1998.

Méthodes:

Des experts canadiens, américains et européens en neurologie, des représentants provinciaux et territoriaux des organismes délivrant les permis de conduire, le Conseil canadien des administrateurs en transport motorisé, l’Association canadienne de protection médicale et l’Association médicale canadienne y ont participé. Une version éditée des bandes sonores transcrites a été rédigée. Les questions iscutées ont été les suivantes: doit-on demander au médecin de rapporter un patient épileptique aux autorités (déclaration obligatoire); quelle est la nature des risques encourus par les conducteurs épileptiques et comment peut-on les quantifier; quelle serait une loi raisonnable régissant la conduite routière des épileptiques au Canada.

Résultats:

Le consensus parmi les experts médicaux était que la déclaration obligatoire devrait être abolie au Canada et qu’une période de 6 à 12 mois sans crise était appropriée avant que la plupart des patients ne puissent conduire une automobile. Les experts croient également que ces standards devraient être uniformes à travers le Canada. Il existait un profond désaccord concernant la recommandation de l’Association médicale canadienne stipulant que tous ces conducteurs doivent être rapportés aux autorités provinciales délivrant les permis de conduire, même dans les provinces n’ayant pas de règles concernant la déclaration obligatoire.

Conclusions:

Les médecins devraient être familiers avec les règlements concernant l’épilepsie et la conduite d’un véhicule motorisé dans les provinces où ils pratiquent et respecter ces règlements. Néanmoins, les données actuelles ne supportent pas la déclaration obligatoire des conducteurs épileptiques par les médecins et les neurologues ont recommandé que ce règlement soit aboli partout au Canada. On devrait également envisager de raccourcir la période sans crise avant d’autoriser la conduite d’une automobile.

Type
Review Article
Information
Canadian Journal of Neurological Sciences , Volume 29 , Issue 4 , November 2002 , pp. 315 - 325
Copyright
Copyright © The Canadian Journal of Neurological 2002

References

1. Matthews, ML, Moran, AR. Age differences in male drivers’ perception of accident risk: the role of perceived driving ability. Accid Anal Prev 1986;18:299–313.Google Scholar
2. Dubinsky, RM, Stein, AC, Lyons, K. Practice parameter: risk of driving and Alzheimer’s disease (an evidence-based review): report of the quality standards subcommittee of the American Academy of Neurology. Neurology 2000; 54: 2205–2211.CrossRefGoogle Scholar
3. Gastaut, H, Zifkin, BG. The risk of automobile accidents with seizures occurring while driving. Neurology 1987;37:1613–1616.CrossRefGoogle ScholarPubMed
4. Taylor, J, Chadwick, D, Johnson, T. Risk of accidents in drivers with epilepsy. J Neurol Neurosurg Psychiatry 1996;60:621–627.Google Scholar
5. Sonnen, AE. Epilepsy and driving: a European view. International Bureau for Epilepsy. Paswerk Bedrijven, Haarlem, The Netherlands 1997:11–32.Google Scholar
6. Krumholz, A. Driving and epilepsy: a historical perspective and review of current regulations. Epilepsia 1994; 35:668–674.Google Scholar
7. Consensus conference on driver licensing and epilepsy: American Academy of Neurology, American Epilepsy Society, and Epilepsy Foundation of America. Washington, D.C., May 31-June 2, 1991. Proceedings. Epilepsia 1994;35:662–705.Google Scholar
8. Drachman, DA, Swearer, JM. Driving and Alzheimer’s disease: the risk of crashes. Neurology 1993;43:2448–2456.CrossRefGoogle ScholarPubMed
9. Salinsky, MC, Wegener, K, Sinnema, F. Epilepsy, driving laws, and patient disclosure to physicians. Epilepsia 1992;33:469–472.CrossRefGoogle ScholarPubMed
10. Hansotia, P, Broste, SK. The effect of epilepsy or diabetes mellitus on the risk of automobile accidents. N Eng J Med 1991; 324: 22–26.Google Scholar
11. Binnie, CD, Marston, D. Cognitive correlates of interictal discharges. Epilepsia 1992;33 (Suppl 6):S11–S17.Google Scholar
12. Krauss, GL, Krumholz, A, Carter, RC, Li, G, Kaplan, P. Risk factors for seizure-related motor vehicle crashes in patients with epilepsy. Neurology 1999; 52:1324–1329.Google Scholar
13. Kasteleijn-Nolst Trenité, DG, Riemersma, JB, Binnie, CD, Smit, AM, Meinardi, H. The influence of subclinical epileptiform EEG discharges on driving behaviour. Electroencephalogr Clin Neurophysiol 1987;67:167–170.Google Scholar
14. Redelmeier, DA, Tibshirani, RJ. Association between cellular-telephone calls and motor vehicle collisions. New Engl J Med 1997; 336: 453–458.CrossRefGoogle ScholarPubMed
15. Waller, JA. Chronic medical conditions and traffic safety. N Engl J Med 1965;273:1413–1420.CrossRefGoogle ScholarPubMed
16. Laberge-Nadeau, C, Dionne, G, Ekoe, JM, et al. Impact of diabetes on crash risks of truck-permit holders and commercial drivers. Diabetes Care 2000;23:612–617.CrossRefGoogle ScholarPubMed
17. McLachlan, RS, Jones, MW. Epilepsy and driving: a survey of Canadian neurologists. Can J Neurol Sci 1997;24:345–349.Google Scholar
18. Van Donselaar, CA, Geerts, AT, Schimsheimer, RJ. Idiopathic first seizure in adult life: who should be treated? BMJ 1991;302:620–623.Google Scholar
19. Zifkin, BG, Kasteleijn-Nolst Trenité, DG. Reflex epilepsy and reflex seizures of the visual system: a clinical review. Epileptic Disord 2000;2:129–136.Google ScholarPubMed
20. Raffle, PAB. The HGV/PSV driver and loss or impairment of consciousness. In: Godwin-Austen, RB, Espir, MLE, (Eds.), Driving and epilepsy. Royal Society of Medicine International Congress and Symposium Series 1983;60:35–39.Google Scholar