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Probability of traffic accidents linked to seizure type in people with epilepsy

3 July, 2007

The chances of people who drive after being diagnosed with epilepsy
having traffic accidents differs depending on the type of seizures they
have, say researchers from the Department of Neurology, Regional University Hospital of Patras.

"For
patients with epilepsy, driving restriction has serious effects on
their quality of life and employability," said Elisabeth Chroni, MD,
PhD.

"On the other hand, if they have a seizure while
driving, they can put themselves and others at risk for severe traffic
accidents and injuries. Therefore, to balance the important social
reasons for driving against the risk to public safety, most countries
have enacted limitations on driving for people prone to epileptic
seizures."

"Identifying risk factors such as the type and
frequency of epileptic seizures might help grading the risk for
accidents in people with epilepsy who drive or are considering
driving," she said.

Dr. Chroni and her colleagues were
attempting to identify clinical risk factors for seizure-related
traffic accidents that should be considered when counselling people
with epilepsy on driving. They conducted a study comparing patients who
had traffic accidents during seizures to patients who continued to
drive after being diagnosed with epilepsy but were not involved in
accidents.

The researchers enrolled 35 people with
epilepsy who continued to drive after their diagnosis. Information
collected from patients and their relatives included the frequency and
types of their seizures, how old they were when their epilepsy started,
the cause of their epilepsy, whether or not they had auras and how
reliable they were; and whether they complied with instructions on
their anti-epileptic medication. Data on their driving was also
collected, including the number of hours per week and years of
experience.

The researchers found that 14 of the 35
patients (40 per cent) had traffic accidents or 'near misses' during
seizures, and seizure type was the only factor that was significantly
different between this group of patients and the other 21 patients.

Of
the 14 patients who had (or almost had) accidents, five had complex
partial seizures. Of the 21 patients who did not have accidents, only
two of them had complex partial seizures.

Having
reliable auras and long seizure-free intervals did not reduce the
probability of accidents, said the researchers. According to the
authors, these results suggest that seizure type should be considered
when consulting patients with epilepsy about driving, bearing in mind
that complex partial seizures are most likely to be associated with an
increased risk of traffic accidents.