Premium
Driving eligibility: Implications of studies on seizure recurrence risk
Author(s) -
Specht Ulrich,
Bien Christian G.
Publication year - 2020
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/ane.13327
Subject(s) - meta analysis , nomogram , medicine , directive , psychology , computer science , programming language
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.