Driving And Seizures: What You Need To Know

If you or a loved one has recently been diagnosed with epilepsy, you might be wondering what the implications are for driving a car or motorbike. Are you still allowed to drive? Are there any restrictions? Do you need to notify the department of motor vehicles (DMV) about your condition?

Does epilepsy increase the risk of accidents?

Epilepsy¹ is a neurological condition that affects approximately three million adults in the United States. While you can suffer from several types of epilepsy, the common characteristic of the condition is epileptic seizures. 

Depending on where they originate in your brain and whether they are focal or generalized, seizures can significantly impair your ability to drive safely. Of particular concern are seizures that result in impaired awareness, loss of consciousness, or uncontrolled motor activity. 

While this can be said for any medication with serious side effects, anti-epileptic medication may also affect your ability to drive safely. Potentially problematic side effects of anti-epileptic drugs include blurred and double vision, fatigue, and tremors. 

A study² in Sweden found that people with epilepsy had a 37% increased risk of being in a serious transport accident compared to people without epilepsy. Interestingly, however, this risk increase was particularly high for cyclists and pedestrians, with only a 1.3-fold increase in the risk of car accidents. 

While the overall risk of driving accidents may only be slightly higher for people with epilepsy, several studies³ have shown that accidents involving people with epilepsy are more likely to result in injury, death, or damage to property than in control groups. 

Can people with epilepsy get a driver’s license?

Regulations that restrict people with epilepsy from getting or keeping their driver’s license have been put in place to limit the damage that people with epilepsy might do to themselves or others if they experience a seizure while driving. 

While some countries prohibit anyone with a history of epilepsy from holding a driver’s license, this is not the case in the United States. As with some other medical conditions, people living with epilepsy need to meet certain conditions before they are allowed to drive legally. These conditions differ from one state to the next, but they generally involve:

• A stipulated ‘seizure-free’ period (for example, six months) before a license will be issued

• A doctor’s evaluation of your ability to drive safely

• Regular submission of medical reports to confirm your improved condition

In most states, the information is submitted to and reviewed by the state’s department of motor vehicles (DMV). In complicated cases, the application may go before a medical advisory board. Some states — such as California, Delaware, Nevada, and Pennsylvania — have mandatory reporting laws that make it obligatory for doctors to notify the DMV about patients with uncontrolled epilepsy. 

The Epilepsy Foundation⁴ has a search function on its website that allows you to look up the laws for each state. You can even make a comparison between the laws in two different states.

Are exceptions made for certain types of seizures?

Regarding driving, certain types of seizures are riskier than others. Some states allow people with epilepsy who experience less risky types of seizures (ones that do not affect consciousness, awareness, or motor control) to drive under certain restricted conditions. 

If, for example, your seizures only occur while you are sleeping, you might be permitted to drive during the day. If your seizures are consistently preceded by a visual aura, a medical board may decide that you have sufficient time to stop the vehicle before the onset of the seizure.  

Do seizures affect commercial driving licenses?

People with epilepsy cannot get a commercial driver’s license if they have ongoing seizures or are seizure-free but still taking anti-epileptic medication. 

If you have a history of epilepsy, you can apply for a commercial driver’s license after being free of seizures and off medication for at least ten years. However, some states may have additional restrictions on these license holders. 

What happens if I have a breakthrough seizure?

Even if you have been driving seizure-free for years, if you have a breakthrough seizure, you need to stop driving and consult your doctor. Your doctor will need to re-evaluate your epilepsy treatment and your ability to drive safely. 

In certain cases, if your license is revoked, you may be able to appeal the decision if the breakthrough seizure occurred under specific circumstances, such as the reduction of medication following your doctor’s advice. 

While giving up your license for a period of time might seem unfair and inconvenient, doing so will help protect you and others on the road. 

Furthermore, if you have a breakthrough seizure and continue to drive regardless — or if you fail to inform the DMV of your epilepsy diagnosis — you can be held civilly or criminally liable for any car accident caused by seizures. 

The lowdown

Living with epilepsy means that you will probably face some sort of restrictions when it comes to applying for a driver’s license. However, this doesn’t necessarily mean that you won’t be able to drive. If your epilepsy is well controlled, you should have no trouble on the road or at the DMV. 

If you already have a driving license when you are diagnosed with epilepsy, you will need to consult your state’s DMV to determine what your responsibilities are with regard to declaring your condition. Doing so will allow you to continue driving safely and legally.