From the Research
After a first-time seizure, you should send a letter to your state's Department of Motor Vehicles (DMV) or equivalent licensing authority reporting the patient's seizure condition. The letter should include the patient's name, date of birth, driver's license number if available, date of seizure, and your medical recommendation regarding driving restrictions, as suggested by the American Academy of Neurology, American Epilepsy Society, and Epilepsy Foundation of America in their 2025 position statement 1. Each state has different reporting requirements, with some states mandating physician reporting while others place the responsibility on the patient. Most states require a seizure-free period of 3-12 months before driving can resume, though this varies by jurisdiction.
You should also document this communication in the patient's medical record and provide the patient with a copy of the letter. Additionally, counsel the patient about the driving restrictions and the rationale behind them - seizures cause temporary loss of consciousness and control, creating significant safety risks while operating a vehicle. This reporting helps protect both the patient and public safety while complying with legal requirements. It's also important to consider the clinical features and prognosis of the patient, as some studies suggest that a first seizure while driving may be an independent predictor of seizure recurrence, supporting a longer period of seizure freedom before returning to driving 2.
Some key points to consider when making this recommendation include:
- The patient's safety and the safety of others on the road
- The potential risks associated with driving after a seizure
- The need for a seizure-free period before driving can resume
- The importance of documenting this communication in the patient's medical record
- The need to counsel the patient about the driving restrictions and the rationale behind them
It's also worth noting that there is variability in driving recommendations for patients with seizures, and some neurologists may recommend shorter driving restrictions than proposed guidelines, often to improve patient autonomy and independence 3. However, it's essential to prioritize the patient's safety and the safety of others on the road when making this recommendation.