To solve the problem of driving a car in epilepsy: by liberalization or by tightening the license?

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Abstract

In the modern mobile world, there is no single solution to the problem of issuing a driving license for patients with epilepsy. Most countries do have liberalized laws that allow driving a car to persons with controlled epilepsy. As far as individuals with regular seizures are concerned, there is a temporary prohibition to drive with potential restoration of the driving right if there is no relapse. The existing experience has shown that such strategy can lead not only to higher quality of life of the patients (more than 70% patients with epilepsy has the right to drive a car), but also to ensure the road safety. Even with this quite liberal approach, about 20% of the drivers with epilepsy do not have their epilepsy fully controlled. In the countries with absolute prohibition of the driving in epilepsy, such as the Russian Federation and China, there is no official statistics on the issue. Based on our practical experience, we concluded on a high (at least 35%) prevalence of drivers among patients with epilepsy; this cannot but increase the risk of road accidents, including fatal. Based on a clinical observation, we illustrate the failure of the mechanisms to prevent road accidents related to epilepsy that are currently in force in the Russian Federation. In our opinion, the problem under discussion does not have an exclusively medical solution. Taking into consideration the accumulated world experience, ensuring of the road safety requires that the state law regulations should be in effect that include a differentiated approached to issuing of permissions to drive a car for persons with epilepsy, from one side, and a serious legal treatment of persons with epilepsy who ignore their adequate therapy and become a cause for road accidents inflicting an injury, from the other.

About the authors

I. V. Ponomareva

Regional Clinical Hospital No. 3

Email: irina_victorovna@mail.ru
ORCID iD: 0000-0001-6499-3054

Irina V. Ponomareva – MD, PhD, Head of Neurological Outpatient Department No. 2, Neurologist, Epileptologist.

287 Pobedy prospekt, Chelyabinsk, 454021

Russian Federation

A. P. Gerzen

Orenburg Regional Clinical Psychoneurological Hospital for War Veterans

Email: antngercen@yandex.ru

Anton P. Gerzen – MD, Head of the Regional Center for Diagnosis and Treatment of Epilepsy, Neurologist, Epileptologist.

202 Komsomol'skaya ul., Orenburg, 460035

Russian Federation

M. N. Lapina

Center for Cardiology and Neurology

Email: pleasant79@mail.ru
ORCID iD: 0000-0001-9910-3285

Marina N. Lapina – MD, Neurologist, Epileptologist, Neurological Center.

8 Verkhosunskaya ul., Kirov, 610007

Russian Federation

M. A. Sherman

Kirov State Medical University

Author for correspondence.
Email: sherman@list.ru
ORCID iD: 0000-0001-5740-1022

Mikhail A. Sherman – MD, PhD, Associate Professor, Head of the Department of Neurology and Neurosurgery.

112 Karla Marksa ul., Kirov, 610998
Tel.: +7 (912) 826 06 05 

Russian Federation

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Copyright (c) 2020 Ponomareva I.V., Gerzen A.P., Lapina M.N., Sherman M.A.

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