Epilepsy and driving: new European Union guidelines.

Driving is often an emotive issue for patients after they have had a seizure. Driving prohibitions impact a patients’ social and economic status. It can be a thorny issue to broach with patients and can create animosity between medical professionals and patients, particularly when work has required driving. In surveys of patients with epilepsy, after the wish to be seizure-free, driving is listed as their primary or secondary concern. 1-3 While driving having active epilepsy clearly poses an increased risk, drivers with epilepsy who are in compliance with driving restrictions and who are controlled on appropriate medications do not pose an excess danger. 4-6 When legislation on driving is clear the situation is much easier for both patients and doctors. Lack of clarity can result in confusion and mistrust between the two groups. In Ireland, unlike the USA, it is not currently mandatory for a physician to report a patient to the driving license authority or their insurance company after the patient has had a seizure. Instead the responsibility lies with the patient to inform the relevant authorities themselves once they have had a seizure. Apart from investigating and treating the patient, the responsibility of the physician is to advise the patient whether they cannot legally drive and for how long. Current Irish guidelines are based on the Road Traffic Regulations of 1999 which was amended in 2004. 7,8 However, on August 25th 2009 the European Union published new amendments to their 2006 Directive of the European Parliament and of the Council on driving licences which is due to be enforced in all member states within a year. 9 This will supersede all prior legislation on the topic and aims to create consistency in driving licensure regulations throughout the European Union (EU). Familiarity with the new legislation will be important for any doctor working in Ireland or any EU member state in the near future.