Driving is almost a necessity for most of us. For many, it enables us to work, socialize and be independent. The loss of a driving licence has a significant impact on a person’s life in so many ways, including keeping your job, getting to and from work, maintaining social contact and accessing daily needs.
Driving and Epilepsy
Driving – why is your health important?
Health is important for public and personal safety on the road. Driving any motor vehicle requires:
- Constant attention
- Good judgement
- Appropriate responses
- Reasonable perception and physical capability
- Good sight and hearing
All of these can be affected by the driver’s physical and psychological health in someone with epilepsy, these factors can also be altered before, during and after a seizure.
NOTE: Commercial vehicle driving involves extra demands due to vehicle (size and load), the responsibility for passengers, the demands of work schedules and distances travelled.
What type of health problems might affect our ability to drive?
Several medical conditions including epilepsy can affect safe driving ability. Examples include sleep disorders, vision problems, heart disease, diabetes, fainting episodes, psychiatric disorders and age-related decline.
The good news is that effectively treated, most people with these conditions can continue to drive. Therefore, it is important to see a doctor and have health problems diagnosed and managed early in some cases, early treatment can stop certain conditions from worsening.
Medical standards for drivers exist to help monitor driver’s health and subsequently support road safety. They are used by general practitioners and medical specialists, when providing medical information to be submitted to the relevant Driving Licence Authority. (DLA)
Epilepsy and seizures
Seizures causing loss of awareness (even if brief and subtle) or loss of muscle control, can impair a person’s ability to control a vehicle.
Your first seizure
After you have your first seizure, or subsequent seizures, the doctor will inform you that you cannot drive and let you know how long you are unable to drive for. This period will depend on what caused the seizure, the seizure type, if it is epilepsy and the type of epilepsy it might be.
When you have your first seizure, ask your treating doctor about driving. You need to follow instruction you given, which will include how long you must refrain from driving.
Once you have met certain criteria you will be able to drive again – safely and legally. Although not everyone will get their licence renewed and others might be issued a conditional licence. Ultimately the decision to suspend or renew a driver’s licence rest with DLA.
Factors considered to reinstate a driver’s licence include; response to treatment, frequency of seizures. electroencephalogram (EEG) findings and the type of epilepsy. It is also important the person feels confident that they can drive safely.
What about seizures that isn’t epilepsy?
Not all people who experience a seizure have epilepsy.
Temporary health problems can occur at any time and may prevent someone from driving in the short term. Examples include a seizure that is provoked by a known cause, such as illness, injury, alcohol pr low blood sugar levels and those not considered epilepsy (they are acute symptomatic seizures).
In these circumstances a doctor will advise a person to restrict their driving for a defined short-term period, unless the circumstances arise again.
Different circumstances that influence licence status
There are several situations in which a variation from the guidelines may be considered by the DLA to allow an earlier return to driving. These are listed and discussed in detail in the Austroads document below;
- Seizures in childhood
- First seizure
- Epilepsy treated for the first time
- Acute symptomatic seizures (mentioned above)
- ‘safe’ seizures”
- Seizures only in sleep
- Seizures in a person whose seizures were previously well controlled
“Safe Seizures are defined as seizures that do not impair driving ability (which requires consciousness and ability to control the vehicle at all times). Normal responsiveness must be tested by reliable witnesses or during video EEG Austroads
Can I keep my driving licence?
Yes. You will be able to retain your licence card for identification purposes and to use when you are safe to drive again,
Who sets the guidelines about whether you are well enough to drive?
The guidelines about health and driving were developed by medical experts and are agreed to by driving licensing authorities nationally. Your doctor or specialist does not make the rules but provide advice, based on the guidelines, about how your epilepsy might affect your ability to drive safely.
The DLA will consider the advice of your doctors, but always makes the final decision about your licence status, Routine use of these guidelines ensures that the fitness to drive of each person is assessed in a consistent manner. Not all seizures or seizure types will pose a risk to driving.
See Austroads website for the Australian Driving Guidelines- Assessing Fitness to Drive for more details.
General considerations
- Any person experiencing seizures, blackouts or episodes of memory loss are advise to see a doctor for testing and evaluation, so the risk of further episodes and the need for treatment can be determined.
- Correct diagnosis of epilepsy or seizure types is important. It means the right treatment is started and assessment for driving can be considered.
- There are some seizure types and circumstances that offer no real danger and have little impact on a person’s driving ability.
Licences
Different licences have different regulations. There are two sets of guidelines, one for drivers of private vehicles and one for drivers of commercial vehicles.
Commercial drivers such as drivers of trucks, public passenger vehicles, emergency services vehicles and vehicles carrying dangerous goods, must meet higher medical standards due to greater safety concerns.
Consideration for reissuing a licence can also be given to people who have been seizure free, for a prolonged periods with or without medication.
Conditional Licences
Advances in medical treatment enables effective management of many conditions, so drivers can remain on the road. However sometimes this requires a conditional licence.
A conditional licence means that the person can continue to drive, if certain conditions or restrictions are met.
Your responsibilities
- It is a legal requirement – you must notify the DLA in your state or territory if you have a seizure, epilepsy or are diagnosed with epilepsy
- You are responsible for ensuring you are well enough to drive safely, have good seizure control and comply with medical treatment
- You must also respond truthfully to questions from health professionals regarding your condition and the likely impact on your ability to drive
- If issued with a conditional licence you are expected to comply with any enforced driving restrictions
- If you are planning any reduction, withdrawal or changing of antiepileptic medication, you must not drive for this period or a period specified by your doctor
- You should avoid circumstances and triggers that are known to increase the risk of your seizures
- It is good practice to have regular reviews with your doctor
The Australian guidelines concerning seizures and driving may seem severe, but these laws were created to protect public safety.
- You must be seizure free for a specified period
- You must continue to take anti-epileptic medication regularly as prescribed unless your specialist recommends changes
- You should ensure that you have adequate sleep and not drive sleep deprived
- You may need to abstain from alcohol and other drugs (it has been found that an episode of seizures may be precipitated by consumption of alcohol or drugs not prescribed for epilepsy)
- It is vital that you feel able and safe to drive
Who tells the authorities?
The law requires you to report to your DLA, any permanent or long – term illness that is likely to affect your ability to drive safely.
What if I don’t tell the authorities?
Driving against medical advice is illegal and dangerous to you, your passengers and the general public. There are many safety factors to consider as seizures often occur without warning.
If you continue driving despite your doctor’s advice and you do not report your condition to the DLA, you are not fulfilling your legal responsibility.
If you are driving and involved in a motor vehicle accident during the recommended non driving period and a seizure was a contributing factor, you may be prosecuted, charged and/or jailed and the conditions of your insurance policy may not be honoured. You may also have difficulty obtaining insurance in the future.
The Doctors role in reporting
As the relationship between you and your doctor is confidential, your doctor will not normally communicate directly with the DLA – he or she will provide you with advice about your ability to drive safely as well as a letter or report to take to the driving authority.
Doctors have an obligation to public safety. If your doctor is aware that you are continuing to drive and feels your driving is a serious risk to you and other road users, he or she may feel obliged to contact the DLA directly.
Can I get financial assistance for travel?
There are taxi subsidies available and Centrelink offers mobility allowance. Both forms of assistance have strict criteria that must be met before they are approved. Your doctor can assist you to complete these forms
Transport Tips
- Car – pooling – ask for a lift from family, friends or colleagues
- Public transport – catch the bus, tram or train
- Ride a bike- if it is safe- off road tracks only if seizures are not controlled
- Walk
- Investigate travel subsidies
For more information
Contact the Driver Licensing Authority (DLA):
- South Australia Department of Infrastructure and Transport
SA.GOV.AU – Driving & Transport
77 Grenfell Street, Adelaide, SA 5000 P: 08 8281 2888
- Northern Territory Department of Transport
18 Goyder Road, Parap, NT 0820 P: 1300 654 628
Reference
Austroads – Assessing Fitness to Drive – July 2021
Epilepsy Australia July 2021
Epilepsy Action Australia July 2021