Driving eligibility: Implications of studies on seizure recurrence risk.

Background: Driving is one of the most important issues for patients with seizures. The 2009 European directive provides a framework for evaluating standard situations in assessing the ability to drive. Such a framework may not be sufficient for individual scenarios.

Aims Of The Study: To analyse current data on seizure recurrence risks (RcRs) focusing on their potential implications for car driving issues (group 1).

Methods: We evaluated current studies and meta-analyses on RcR.

Results: A meta-analysis of seizure-free patients who withdrew their medication (Lamberink et al Lancet Neurology 2017;16:523) created a nomogram and a web-based tool that allow estimating RcR in individual patients and thus to identify those in whom medication withdrawal is possible without the common driving ban during withdrawal. The 2-year prediction model of that meta-analysis has been recently externally tested and confirmed. A meta-analysis of patients with a first unprovoked seizure (Bonnett et al PloS ONE 2014;9:e99063) determined to which extent RcRs depend on established risk factors. The seizure-free period required to restart driving could be tailored according to the individual RcR.

Conclusion: These current studies allow estimating individual RcR more precisely and thus modifying periods of driving bans beyond the existing guidelines.