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Epilepsy and Driving: An International Perspective

Summary: Individuals with a history of seizures may be granted driving privileges if the risks of future seizure while driving are relatively low. Different nations have defined these risks in a wide variety of ways. Some countries, e.g., Japan, Greece, Brazil, India, and Russia, preclude driving after a single seizure. Other countries, suchas Canada and the United States, allow driving 3 months after certain types of seizures. A Joint Commission of the International Bureau for Epilepsy/International League Against Epilepsy has summarized regulations in several countries. From a consideration of med‐ical literature and existing practices, a series of proposedguidelines for driving and epilepsy is recommended. Ingeneral, these guidelines suggest use of a seizure‐free interval, generally 1–2 years but less in particular instances, to determine fitness to drive. Required physician reporting is discouraged, but physicians should report patientswhom they believe pose a danger to themselves and topublic safety. Individualized consideration should begiven to special circumstances that may modify a generaldriving prohibition. Education and information programsare necessary for medical and regulatory authorities to develop a rational approach to driving and epilepsyworldwide.