Should patients with psychogenic nonepileptic seizures be allowed to drive?
OBJECTIVE
To investigate the risk of driving accidents in patients with psychogenic nonepileptic seizures.


METHODS
First, a survey was conducted in 82 physician-members of the American Epilepsy Society to determine what they recommend in patients with psychogenic seizures in regard to driving privileges. Second, we studied a population of 20 patients with proven psychogenic nonepileptic seizures diagnosed by prolonged EEG-video monitoring. We obtained the patients' driving records from the Wisconsin Department of Transportation. We used 1991 Wisconsin crash data as the reference year. We compared the expected number of motor vehicle crashes with the observed number of crashes. chi2 with Yates' correction for continuity was used to test for statistical significance.


RESULTS
Of the 82 physicians questioned, 37 (45%) responded. Among respondents, the distribution was as follows: 49% applied the same restrictions as for patients with epilepsy; 32% did not place patients under any restrictions; and 19% decided on a case-by-case basis. The total number of reported crashes in the sample was eight, with no fatal crashes. This was not statistically significant (corrected chi2, 0.53) compared with the expected number of motor vehicle crashes for the sample.


CONCLUSIONS
This small series does not support the use of driving restrictions for patients with psychogenic nonepileptic seizures.
Benbadis
S R
SR
Departments of Neurology & Neurosurgery, University of South Florida College of Medicine, Tampa, Florida 33606, USA. sbenbadi@hsc.usf.edu
Blustein
J N
JN
Sunstad
L
L
D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001333:Automobile Driver Examination / Q000331:legislation & jurisprudence; D001334:Automobile Driving / Q000331:legislation & jurisprudence*; D004569:Electroencephalography / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000706:statistics & numerical data; D009462:Neurology; D012307:Risk Factors; D012640:Seizures / Q000175:diagnosis / Q000523:psychology*; D013001:Somatoform Disorders / Q000175:diagnosis / Q000523:psychology*; D014743:Videotape Recording; D014922:Wisconsin