title: Epileptic auras and their role in driving safety in people with epilepsy.
abstract: The aim of our study was to evaluate the role of auras in preventing motor vehicle accidents (MVAs) among patients with medically refractory epilepsy. The Multicenter Study of Epilepsy Surgery database was used to perform a case-control study by identifying patients who had seizures while driving that led to MVAs (cases) and those who had seizures while driving without MVAs (controls). We compared presence of reliable auras and other aura-related features between the two groups. Two hundred fifteen of 553 patients reported having seizure(s) while driving; 74 were identified as "controls" and 141 as "cases." The two groups had similar demographic and clinical features. The presence of reliable auras was not different between the two groups (67% in cases vs. 65% in controls; odds ratio [OR] 0.89, 95% confidence interval [CI] 0.49-1.61, p = 0.76). In addition, the groups did not differ in the proportion of patients who reported longer (>1 min) auras (OR 0.7, 95% CI 0.28-1.76, p = 0.47), or who thought that their auras were of sufficient duration to be protective (OR 1.19, 95% CI 0.62-2.00, p = 0.77). Our study questions the long-held belief of a protective role of reliable auras against MVAs in people with epilepsy.
authors.affiliation: Departments of Neurology, Yale University School of Medicine, New Haven, Connecticut, U.S.A.
authors.forename: Vineet
authors.initials: V
authors.lastname: Punia
authors.affiliation: Departments of Neurology, Yale University School of Medicine, New Haven, Connecticut, U.S.A.
authors.forename: Pue
authors.initials: P
authors.lastname: Farooque
authors.affiliation: Departments of Neurology, Yale University School of Medicine, New Haven, Connecticut, U.S.A.
authors.forename: William
authors.initials: W
authors.lastname: Chen
authors.affiliation: Departments of Neurology, Yale University School of Medicine, New Haven, Connecticut, U.S.A.
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Hirsch
authors.affiliation: Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Epilepsy Center, Chicago, Illinois, U.S.A.|Department of Pediatrics, Northwestern Memorial Feinberg School of Medicine, Chicago, Illinois, U.S.A.
authors.forename: Anne T
authors.initials: AT
authors.lastname: Berg
authors.affiliation: Departments of Neurology, Yale University School of Medicine, New Haven, Connecticut, U.S.A.|Departments of Neurobiology, Yale University School of Medicine, New Haven, Connecticut, U.S.A.|Departments of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut, U.S.A.
authors.forename: Hal
authors.initials: H
authors.lastname: Blumenfeld
mesh_terms: D000063:Accidents, Traffic / Q000517:prevention & control*; D001334:Automobile Driving / Q000592:standards; D016022:Case-Control Studies; D016208:Databases, Factual; D004827:Epilepsy / Q000150:complications* / Q000175:diagnosis*; D006801:Humans
keywords: Auras; Driving; Epilepsy; Motor vehicle accidents; Seizures