In a position statement issued by the American Academy of Neurology and published online March 12 in Neurology, an updated consensus is presented relating to seizures, driving licensure, and medical reporting.

Benjamin Tolchin, M.D., from the Yale School of Medicine in New Haven, Connecticut, and colleagues reviewed the evidence relating to driving safety in the setting of seizures and developed a revised position statement to update those published in 1994 and 2007.

The authors present key consensus positions, including national driving standards promulgated through a system such as the Uniform Law Commission, which would reduce confusion and improve adherence to state driving standards in the United States, as well as the promulgation of state licensing criteria for medical conditions by regulations and guidelines based on enabling legislation rather than in statutes, with development by medical advisory boards working with departments of motor vehicles.

Licensing criteria should be equitable, nondiscriminatory, objective, and compatible with similar risks in other populations. In all cases, a minimum seizure-free interval of three months should usually be required before driving based on review of favorable and unfavorable features; this interval can be extended by medical advisory boards in individual cases.

A seizure-free interval may not be required before resuming driving for individuals with exclusively provoked seizures attributable to provoking factors that are unlikely to recur. Driving should be paused during tapering and following discontinuation of an antiseizure medication if another such medication is not introduced. Health care practitioners should be allowed but not mandated to report drivers posing elevated risk.

“This position statement aims to improve the management of this complex personal, medical, governmental, and societal issue,” Tolchin said in a statement.

Two authors disclosed ties to the pharmaceutical and biotechnology industries.

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