2010 BC Guide in Determining Fitness to Drive
2010 BC Guide in Determining Fitness to Drive 2010 BC Guide in Determining Fitness to Drive
22.14 Commercial drivers with atypical vasovagal syncope, unexplained syncopeor recurrent typical vasovagal syncopeApplicationAssessment guidelinesFitness guidelinesOSMV determinationguidelinesConditionsRestrictionsRe-assessmentguidelinesThese guidelines apply to driver fitness determinations forcommercial drivers who have had: single or recurrent atypical vasovagal syncope single or recurrent unexplained syncope, or recurrent typical vasovagal syncopewithin a 12 month period.Typical vasovagal syncope is a vasovagal syncope that occurs whenstanding and is preceded by warning signs that are sufficient to allowa driver to pull off the road before losing consciousness.Atypical vasovagal syncope is a vasovagal syncope that occurs in thesitting position or is not preceded by warning signs that are sufficientto allow a driver to pull off the road before losing consciousness.If further information is required, OSMV will request: a Driver’s Medical Examination Report, or additional information from the treating physician.Individuals may drive if it has been at least 12 months since their lastepisode of syncope.OSMV may find individuals fit to drive if it has been at least 12months since their last episode of syncope.OSMV will impose the following conditions on an individual who isfound fit to drive: you must routinely follow your treatment regime and physician’sadvice regarding prevention of syncope, and you must report to OSMV and your physician if you have anotherepisode of syncope.No restrictions are required.OSMV will re-assess in one year. If no further episodes of syncopeare reported at that time, no further re-assessment is required, otherthan routine commercial re-assessment.298
Chapter 23: Seizures and EpilepsyBACKGROUND23.1 About seizures and epilepsySeizuresA seizure is caused by a sudden electrical discharge in the brain. A seizure does not alwaysmean that a person falls to the ground in convulsions. It can be manifested in various ways,including: feelings of being absent visual distortions nausea vertigo tingling twitching shaking rigidity of parts of the body or the entire body, or an alteration or loss of consciousness.Seizures may occur in people who do not have epilepsy. These non-epileptic seizures are oftenreferred to as provoked seizures. Some are caused by transient factors with no structural brainabnormality such as: fever low blood sugar electrolyte imbalance head trauma meningitis simple fainting, and alcohol or drug toxicity or withdrawal.Others are caused by conditions where there is a structural brain abnormality such as a: tumour stroke aneurysm, or hematoma.Provoked seizures are not epilepsy, and they resolve after the provoking factor has resolved orstabilized.Sometimes people appear to have seizures, even though their brains show no seizure activity.This phenomenon is called a non-epileptic psychogenic seizure (NEPS), sometimes referred to as299
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22.14 Commercial drivers with atypical vasovagal syncope, unexpla<strong>in</strong>ed syncopeor recurrent typical vasovagal syncopeApplicationAssessment guidel<strong>in</strong>es<strong>Fitness</strong> guidel<strong>in</strong>esOSMV determ<strong>in</strong>ationguidel<strong>in</strong>esConditionsRestrictionsRe-assessmentguidel<strong>in</strong>esThese guidel<strong>in</strong>es apply <strong>to</strong> driver fitness determ<strong>in</strong>ations forcommercial drivers who have had: s<strong>in</strong>gle or recurrent atypical vasovagal syncope s<strong>in</strong>gle or recurrent unexpla<strong>in</strong>ed syncope, or recurrent typical vasovagal syncopewith<strong>in</strong> a 12 month period.Typical vasovagal syncope is a vasovagal syncope that occurs whenstand<strong>in</strong>g and is preceded by warn<strong>in</strong>g signs that are sufficient <strong>to</strong> allowa driver <strong>to</strong> pull off the road before los<strong>in</strong>g consciousness.Atypical vasovagal syncope is a vasovagal syncope that occurs <strong>in</strong> thesitt<strong>in</strong>g position or is not preceded by warn<strong>in</strong>g signs that are sufficient<strong>to</strong> allow a driver <strong>to</strong> pull off the road before los<strong>in</strong>g consciousness.If further <strong>in</strong>formation is required, OSMV will request: a <strong>Drive</strong>r’s Medical Exam<strong>in</strong>ation Report, or additional <strong>in</strong>formation from the treat<strong>in</strong>g physician.Individuals may drive if it has been at least 12 months s<strong>in</strong>ce their lastepisode of syncope.OSMV may f<strong>in</strong>d <strong>in</strong>dividuals fit <strong>to</strong> drive if it has been at least 12months s<strong>in</strong>ce their last episode of syncope.OSMV will impose the follow<strong>in</strong>g conditions on an <strong>in</strong>dividual who isfound fit <strong>to</strong> drive: you must rout<strong>in</strong>ely follow your treatment regime and physician’sadvice regard<strong>in</strong>g prevention of syncope, and you must report <strong>to</strong> OSMV and your physician if you have anotherepisode of syncope.No restrictions are required.OSMV will re-assess <strong>in</strong> one year. If no further episodes of syncopeare reported at that time, no further re-assessment is required, otherthan rout<strong>in</strong>e commercial re-assessment.298
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