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Driving restriction is a well-known undesirable consequence of epilepsy and causes significant problems regarding independence and employment for epileptic patients. Many countries all over the world have provided comprehensive protocols in this regard with the aim of providing the possibility of less restricted, but safe driving for epileptic patients and also providing the opportunity for uniform decision-making for clinicians. However, the available fitness to drive protocol in Iran still lacks sufficient details and clinicians might encounter serious problems in terms of the driving issue in epileptic patients. In order to provide a uniform protocol containing adequate practical data, a systematic review of literature addressing guidelines about driving and epilepsy and driving laws of different countries for epileptic patients was performed and, after consideration of cultural issues, a practical protocol for Iranian neurologists was suggested.IntroductionThe negative impact of seizures on the quality of life (QOL) of epileptic patients has been acknowledged. Seizures particularly influence the social aspects of life including work, driving, interpersonal relations, and education.1-10 One of the most restricting factors of epilepsy is prohibition of driving that might have adverse effects on QOL, independence, and working capabilities.11-15 The main rationale behind limited rules for driving in epileptic patients is obviously the risk of occurrence of seizure during driving that might lead to significant injuries in patients and others. The first traffic accident due to a seizure has been reported in 1906,16 and for a few decades after that, a permanent driving ban law was enforced for all epileptic patients.17 Gradually, with the initiation of diagnostic advances and more common use of first antiepileptic drugs (AEDs), the conditional driving license in certain circumstances was allowed and some countries started to provide a comprehensive protocol to cover different types of seizures with the aim of providing the

Fitness to drive in seizure and epilepsy: A protocol for Iranian clinicians