It's a common assumption that people with epilepsy can't drive, but this isn't always the case. Depending on the state in which you live, you may need to be seizure-free for a specific period of time, submit a physician's evaluation of your ability to drive safely, or produce medical records in order to get behind the wheel. But if you meet these must-have requirements and your epilepsy is well-controlled, you may be able to drive safely and legally.
"The issue of driving with epilepsy is a difficult one because the ability to drive is key to so many important things in life," says Alan Haltiner, MD, a neuropsychologist who works with people with epilepsy at the Swedish Neuroscience Institute in Seattle. The first step in trying to gain this ability is to become familiar with the specific laws governing driving with epilepsy that apply to you.
Good epilepsy management is one part of being able to drive with epilepsy, but because of the risk for seizures, it's not the only part. As you get familiar with your local laws, remember that they're designed to protect your safety as well as the safety of others on the road.
Who Can Drive With Epilepsy
Whether you can drive with epilepsy depends on the safety requirements established by the state where you live. If your epilepsy involves recent seizures that have altered your awareness, consciousness, or muscle control, you may not have the legal right to drive. However, you may be able to get behind the wheel if you have been seizure-free for a specific period of time and have a note from your doctor stating that your seizures are well-controlled and you do not pose an unreasonable risk to public safety. "In most states, you have to be seizure-free for at least 6 months," Dr. Haltiner says.
But this required period of absent seizures varies. For example, in Maine you must be seizure-free for at least 3 months and on medication to control your epilepsy. You must also have your epilepsy evaluated every 4 years. The state of New Jersey is a little stricter - you must be seizure-free for at least a year in order to drive. On the other hand, the state of Montana requires no seizure-free period but you will need a physician's verification that your condition has stabilized and is not likely to interfere with your ability to operate a motor vehicle safely.
The Dangers of Driving With Epilepsy
Despite the restrictions on driving with epilepsy, Haltiner says that a lot of people simply ignore them. "It is amazing how many people drive in spite of having poorly controlled epilepsy," he says. "I see patients who come into the hospital for video monitoring to determine treatment options based on seizures they are currently having, and I sometimes find out they got to the hospital by driving themselves. These people put themselves and others at significant risk."
The biggest hazard that people without proper epilepsy management face if they drive is the chance of having a seizure while behind the wheel. "During a seizure, you could lose control of your vehicle and potentially injure yourself or others," Haltiner says. "You also face significant liability if you drive despite having documentation that you've been told you shouldn't."
Haltiner says that people with epilepsy also can lose focus behind the wheel even if they don't lose consciousness. "Anything that involves the inability to control a vehicle in a situation when you need to react quickly is a concern," he says.
Add to these risks the fact that some drugs used to control epilepsy can make you drowsy. If you just started a new drug as part of your epilepsy management, you should avoid driving until you know how it affects you.
Haltiner explains that some people with epilepsy are overly confident in their ability to sense an oncoming seizure with warning signs, like aura, in time to pull over while driving. "There is always the risk that you will experience a seizure different from any you have ever had before," he says.
"Another significant safety issue," Haltiner adds, "is people with epilepsy who do not follow their correct treatment protocol." Not taking antiepileptic medication as prescribed for proper epilepsy management - missing a dose, for example - increases your chances of having an accident. So if you choose to drive, it's particularly important that you take your medication exactly as directed by your physician.
What the Law Says About Driving With Epilepsy
The laws governing driving with epilepsy vary from state to state, and these laws - not the physician who treats your epilepsy - determine whether you can drive safely and legally. However, your physician will be able to explain these laws and help you determine whether you meet the criteria for driving with epilepsy.
As someone with epilepsy, you may have to provide written proof from your doctor that your seizures are under control before you can apply to get a driver's license.
Another factor to be aware of is whether your state requires physicians to report epilepsy patients unfit to drive to a central state agency. "In Washington State, physicians are not required to report seizure patients to the Department of Motor Vehicles," Haltiner says. "In fact, I could be charged with divulging confidential medical information if I did. However, two states away, in California, doctors must report unsafe drivers with epilepsy and can have their [medical] licenses revoked if they fail to do so." Only five states in addition to California - Delaware, Nevada, New Jersey, Oregon, and Pennsylvania - require physicians to report patients who have seizures.
The punishment if you are caught driving with epilepsy without meeting the necessary requirements also varies from state to state. In general, if you drive against medical advice or without a valid license and have a seizure-related accident, you risk civil and criminal liability.
Haltiner sums it up best: If you've been instructed not to drive, the potential hazards of getting behind the wheel aren't worth it - to yourself or to others. As someone with epilepsy, it's your responsibility, he says, to follow your physician's advice and try to cope with your seizures in a safe, meaningful way.
Last Updated: 6/28/2013