Introduction from Dr Markus Reuber, editor-in-chief of Seizure
Neurologists regularly have to tell patients that they have epilepsy. Their explanation of this diagnosis will cover many difficult topics, including further investigations to rule out potentially serious underlying causes, the need for long term medication, the possibility of side-effects from medication, contraception, genetic risks, seizure-related injuries, the dangers associated with prolonged seizures and the small but important risk of sudden unexpected death. Predictably patients look anxious and upset when they hear so much bad news. What is more surprising is that many patients seem to be able to take all this in until the conversation turns to the topic of driving. Not uncommonly, the idea of losing their driving licence triggers a greater emotional reaction than all of the other items listed above. In Western countries, the permission to drive a car has almost acquired the status of a human right. Holding a driving licence has a much wider meaning than being allowed to drive a car on a public highway. This means that driving restrictions need to be designed on rational grounds and applied fairly. The review by Winston and Jaiser in this issue of Seizure summarises our (limited) knowledge about driving and epilepsy and the thinking behind driving policies. It also demonstrates how much work there is still to do in this area of crucial importance to people with epilepsy.