Seizures While Driving Highlight Importance of Early Focal Epilepsy Awareness, Diagnosis

The prevalence of seizures while driving (SzWD) prior to diagnosis in people with focal epilepsy suggests how improved awareness and early intervention may reduce the burden of hospitalizations and injuries due to seizure-related motor vehicle accidents (MVAs).

“Seizures while driving pose substantial risks for those experiencing them and for others on the road,” said senior study author Jacob Pellinen, MD, of the University of Colorado in Aurora and a member of the American Academy of Neurology, in a statement.¹ “While medication may make it possible for some people with epilepsy to safely drive, they must first be diagnosed.”

The full retrospective cohort study is published in Neurology.²

Using data collected from epilepsy diaries and medical records, researchers aimed to identify seizure types, frequencies, time to diagnosis, and the impact of SzWD in people with focal epilepsy prior to diagnosis.

The study included 447 participants enrolled in the Human Epilepsy Project (EHP), a multinational study of individuals with newly treated focal epilepsy. EHP data included seizure frequency, seizure characteristics, treatment initiation, and date of diagnosis. Additional information included were the prevalence of prediagnostic SzWD, the number of SzWD-associated hospitalizations, treatments, and diagnostic tests.

Of the total, the average age patients experienced their first seizure was 29 years, and 23 (5%) individuals experienced 1 or more SzWD, accounting for a total of 32 SzWD prior to diagnosis.

Additionally, 7 of the 23 (30%) individuals had more than 1 seizure while driving prior to diagnosis, and 6 (26%) individuals reported their seizure while driving was the first seizure they experienced. Furthermore, the average time a patient experienced their first seizure to experiencing a seizure while driving was 304 days, and from a person’s first seizure while driving to diagnosis, 64 days.

As a result of these seizures, there were 19 MVAs and 11 hospitalizations for injuries, which varied in severity from a tongue bite and a dislocated thumb to nearly drowning.

After analysis, the researchers found people who were employed had a 4-times greater risk of experiencing a seizure while driving prior to diagnosis than those who were not employed (95% CI, 1.2-13.2; P = .03). Individuals who experienced nonmotor seizures, in which movement stops or a person will stare, had nearly 5-times greater risk of experiencing a seizure while driving prior to diagnosis than those who had a motor seizure (95% CI, 1.13-17.6; P = .02).

The researchers acknowledge there were some limitations to their study, including that some of the data on seizure history were patient reported, which may have led to bias; a patient not remembering correctly; and an underreporting of seizures experienced.

Despite these limitations, the researchers believe this study highlights the importance of education and awareness surrounding early detection and intervention for people with focal epilepsy to reduce the prevalence of seizure-related MVAs.

“Considering the United States has a population of just over 200 million people between ages 16 and 64, and considering the annual incidence of epilepsy, there are roughly 126,180 driving-age people in the country diagnosed with epilepsy each year,” said Pellinen.¹ “From our study, we estimate nearly 6500 people per year may experience prediagnosis seizures while driving in the United States alone, leading to nearly 4000 possible motor vehicle accidents and over 2200 hospitalizations. Much of this may be preventable by earlier diagnosis.”

References

1. Seizures while driving and why it’s important to diagnose epilepsy ASAP. News release. EurekAlert! June 7, 2023. Accessed June 26, 2023. https://www.eurekalert.org/news-releases/991196

2. Bases B, Barnard S, French JA, Pellinen J. Impact of seizures while driving prior to diagnosis in people with focal epilepsy: motor vehicle accidents and time to diagnosis. Neurology. Published online June 7, 2023. doi:10.1212/wnl.0000000000207464