Epilepsy and driving; impact on the patient and the society - experience from a South Asian cohort

Background Road traffic accidents are a leading cause of morbidity and mortality in Sri Lanka. Although it is a statutory requirement to declare epilepsy before applying for a driving license, the regulations are not well defined. Parallel to the developing transportation infrastructure and the increasing need of driving skills for independence, the impact of epilepsy on driving has become a topic of utmost importance. Methods This is a descriptive observational study. All patients followed up at the National epilepsy center at National hospital of Sri Lanka, who fulfill the international league against epilepsy (ILAE) operational definition of epilepsy were recruited for the study for a period of three months starting from November 2022 to March 2023. Results The study evaluated 142 participants, the majority of whom were males (98%). Only 68 (47.9%) of them were seizure free for more than 2 years. Most of them were on at least two anti-seizure medications. MRI evidence of a lesion was present on 36 (25.4%) participants. 41 (28.9%) of them have faced road traffic accidents as the driver of the vehicle and some have experienced up to 4 road traffic accidents. Out of the 55 road traffic accidents reported by the participants, 13 were due to either development of seizure or aura. Conclusion The advances in transport medicine in many countries have enabled the medically disabled to drive with less restrictive solutions while ensuring road safety. This study highlights the need for formal guidelines on driving with epilepsy, considering the individual medical, financial, and social requirements.