2010 BC Guide in Determining Fitness to Drive

Parkinson’s diseasePD can affect motor, visual, and cognitive functioning. Common motor symptoms include: tremor rigidity bradykinesia/akinesia (slowness or absence of movement/rapid repetitive movements), and postural instability.Visual impairments such as contrast sensitivity, diplopia (double-vision) and impaired eyemovement are sometimes seen in PD and related movement disorders. Cognitive symptoms mayinclude psychiatric conditions such as depression, impulse control disorders, and psychosis, aswell as sleep disturbances, psychomotor slowing (slow response and reaction time), cognitiveimpairment and dementia.In addition to the symptoms noted above, fatigue and sleep disturbances are common in thosewith PD.The symptoms of PD are often treated with medications including levodopa, dopamine agonists,and MAO-B inhibitors. These medications can cause side effects including sleepiness, sleepattacks (sudden, overwhelming sleepiness with little or no warning signs) and visualhallucinations, which may affect driving.A further consideration for driving is the fluctuation in the effects of medication. Individualswith advanced PD may experience periods of reduced symptom control (wearing off) near thetime of their next dose of medication.Cerebral palsyCP can affect motor, visual, and cognitive functioning. The primary effects of CP are: ataxia (wobbliness, incoordination and unsteadiness) weakness and spasticity (involuntary muscle spasms), and altered muscle tone that is either too stiff or too floppy.CP can also cause a loss of visual acuity or slowed visual tracking, as well as cognitiveimpairments such as impaired judgment and slow processing or reaction times.320