by American Academy of Neurology

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The American Academy of Neurology (AAN), the American Epilepsy Society (AES) and the Epilepsy Foundation of America (EFA) have issued a consensus position statement on seizures, driver licensure and medical reporting.

The position statement is published online in Neurology. It was developed with the Ethics, Law, and Humanities Committee, a joint committee of the AAN, the American Neurological Association and the Child Neurology Society.

This statement updates a 1994 consensus statement by the AAN, AES, and EFA as well as a 2007 AAN position statement.

"Driving provides independence for work and daily tasks, but there is a modest increase in the risk of car accidents associated with seizures, " said author Benjamin Tolchin, MD, of the Yale School of Medicine in New Haven, Connecticut, and a Fellow of the American Academy of Neurology.

"Most people with epilepsy can drive safely when seizures are controlled by medication, and for some, seizures stop over time. This position statement aims to improve the management of this complex personal, medical, governmental and societal issue."

The position statement says for people with seizures, a medical advisory board should conduct an individualized risk assessment and require a seizure-free period of three months or longer prior to driving, depending on the features of a person's individual case. Driving should be paused during tapering of a drug and following discontinuation of a medication if another drug is not replacing it.

"Neurologists diagnose and treat epilepsy, and are experts in brain health, " said American Academy of Neurology President Carlayne E. Jackson, MD, FAAN.

"With their expertise in managing seizures, this position statement can help medical professionals and government officials advise people who want to drive safely, ultimately improving their quality of life."

The position statement says driver licensing decisions should be made by governmental regulatory bodies, rather than health practitioners.

Additionally, health practitioners should be allowed, but not required, to report drivers who pose an elevated risk, noting that mandatory reporting by health care practitioners does not reduce accidents or fatalities but does increase the likelihood of people driving without a license and withholding information about seizures from their doctors.

"Through collaboration with multiple organizations, committees, and patient representatives, we have developed a framework that reflects a balanced approach to safety and patient independence and prioritizes individualized risk assessment while ensuring that regulatory bodies—not health care providers—make licensing decisions, " said author Charuta Joshi, MBBS, MSCS, CSCN(EEG), and a Fellow of the American Epilepsy Society.

"This position statement and the consensus behind it underscore the importance of medical advisory boards in assessing seizure-related driving risks while recognizing the unintended consequences of mandatory physician reporting."

The position statement says alternative methods of transportation and accommodation should be provided by government agencies for people whose driving privileges are restricted due to medical conditions.

"Driving is a central factor for quality of life, helping people with epilepsy maintain employment, access needed health care, and engage socially, " said Bernice Martin Lee, Chief Executive Officer of the Epilepsy Foundation of America.

"The new recommended position statement is data-driven and creates a thoughtful balance between personal independence and well-being and public safety."

More information: Neurology (2025). Journal information: Neurology