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Compulsory reporting of seizures can have "negative impact"

8 April, 2003

Requiring doctors to report their patients' seizures to driving authorities can lead patients to withhold information from their doctors and can harm the doctor-patient relationship, according to research presented to the American Academy of Neurology Annual Meeting.

The study surveyed epilepsy patients in California, one of six states in the USA requiring doctors to report any episodes of loss of consciousness to the state health department. Some patients had already concealed information about their seizures from their doctors in fear of losing their drivers' licences and others had considered doing so, according to the study's lead author, neurologist Dr Kamala Rodrigues who was at Stanford University in California.

Dr Rodrigues said:

"This is dangerous, because if doctors don't know that their patients are having seizures, they can't work with them to alter their medications to control the seizures. The law was designed with the assumption that it would protect public safety, but there's no evidence to prove that assumption is true. This study shows that mandatory reporting may lead to more uncontrolled seizures, which could be a greater risk to the public."

The survey was given to all adult patients of the Stanford Epilepsy Clinic. Of 402 surveys sent, 207 were returned, all anonymously. Of those, 44 per cent were currently driving; 77 per cent had driven in the past. Of those who responded to questions on concealment, 8.6 per cent said they had concealed information on their seizures from their doctor due to fear of losing their driver's licence. Nineteen per cent had considered withholding seizure information. California's mandatory reporting requirement had a negative impact on their relationship with their doctor, according to 22 of 166 patients responding.

Dr Rodrigues commented:

"Our concern is that this will at least weaken the lines of communication between patient and doctor and at worst cause patients to go without treatment if they avoid medical care. Not only is this dangerous to the health of individual patients, but it also defeats the initial goal of the mandatory reporting law."