From the Research
The recommended waiting period after a seizure before allowing a patient to drive is typically 6 months, as this allows for a significant reduction in the risk of seizure recurrence, with the risk falling to 15% at 3 months after withdrawal and 17% at 12 months after restarting treatment, as seen in the study by 1.
Key Considerations
- The waiting period may be shorter (3-6 months) for provoked seizures with correctable causes, such as those triggered by medication reactions, alcohol withdrawal, or acute illness.
- However, the waiting period may be longer (12 months or more) for patients with certain high-risk conditions like uncontrolled epilepsy or seizures that occur without warning.
- During this waiting period, patients should continue taking their prescribed antiseizure medications as directed, such as levetiracetam (Keppra), lamotrigine (Lamictal), or carbamazepine (Tegretol), and attend all follow-up appointments with their neurologist.
Risk of Seizure Recurrence
- The risk of seizure recurrence is highest in the months immediately following a seizure event, with a risk of 30% in the next 12 months after treatment withdrawal, as seen in the study by 1.
- The risk of seizure recurrence decreases over time, with a risk of 15% at 3 months after withdrawal and 17% at 12 months after restarting treatment, as seen in the study by 1.
Driving Restrictions
- Patients should be aware that driving restrictions are legally mandated in most places, and driving against medical advice may invalidate their auto insurance and result in legal consequences if an accident occurs.
- The study by 2 provides a quantitative approach to decisions regarding a return to driving in patients with first-ever provoked or unprovoked seizure, with a recommended non-driving period of 8 months for unprovoked first-ever seizure and 5 months for provoked first-ever seizure.
Individualized Approach
- The decision to allow a patient to drive after a seizure should be individualized, taking into account the patient's specific condition, the risk of seizure recurrence, and the potential consequences of a seizure while driving.
- The study by 3 highlights the importance of individualized risk assessments, with a recommended seizure-free period of 6 months for patients with a low risk of seizure recurrence.