2010 BC Guide in Determining Fitness to Drive

more than half of newly diagnosed individuals with epilepsy can achieve seizure control withanti-epileptic drugs. Many of those who achieve seizure control are eventually able to stoptaking anti-epileptic drugs and remain seizure-free. However, the relapse rate with drugwithdrawal is at least 30 to 40%. For a further discussion of the impact of anti-epileptics ondriving, see Chapter 29 – Psychotropic Drugs.23.2 Prevalence and incidence of seizures and epilepsyResearch indicates that up to 9% of the general population will have at least one seizure.Epilepsy has an overall prevalence rate of 0.6% in Canada, with an estimated incidence of15,500 new cases per year (2003). The table below shows the prevalence of epilepsy in Canadaby age. 15Age (years) Prevalence (%) Age (years) Prevalence (%)0 – 11 0.3 25 – 44 0.712 – 14 0.6 46 – 64 0.716 – 24 0.6 > 65 0.723.3 Seizures and epilepsy and adverse driving outcomesResearch indicates that, in general, individuals with epilepsy have an increased risk for adversedriving outcomes. Variability in the methodology and study results makes it difficult todetermine the extent of the increased risk.Studies of crash rates indicate that the following factors increase the risk of crash for those withepilepsy: age – younger drivers have increased risk, particularly those under 25marital status – unmarried drivers are at a greater risk than married drivers, andtreatment – those not receiving anti-epileptic drug treatment are at greater risk than thosereceiving treatment.23.4 Effect of seizures and epilepsy on functional ability to driveThe primary consideration for drivers with epilepsy is the potential for a seizure causing asudden impairment of cognitive, motor or sensory functions, or a loss of consciousness whiledriving.15 Source: Data from Ontario Health Survey, Community Health Survey and National Population Health Survey(Wiebe S, Bellhouse D, Fallary C, Eliasziv M. Burden of epilepsy: the Ontario health survey. Can J Neurol Sci1999;26:263-70).302