Driving Impairment Caused by Episodic Brain Dysfunction

Abstract

Dangerous driving by drivers with diseases or disabilities such as dementia, epilepsy, or higher brain dysfunction is viewed as a problem In Worldwide. Given that the majority of such cases of dangerous driving are caused by impairments to cognitive function resulting from these conditions, there is an urgent need to create systems to detect drivers with cognitive functional disability and develop criteria for safe resumption of driving. Because driving would understandably be extremely dangerous for people with higher brain dysfunction, particularly in cases of attention dysfunction, we first examined the correlation between the Clinical Assessment of Attention (CAT), a theoretical task offering an index of attention function, and the cathode ray tube (CRT) driving aptitude test. We then examined correlations between CRT total score and CRT sub-scores. Only the time required for the position Stroop test had a moderate correlation (r = -0.43, p < 0.01) with CRT total score. Correlations between CRT total score and sub-scores relating to reaction speed showed a strong correlation. Other than reaction speed, items with significant moderate to strong correlations were also seen in the maintenance of moderate mental tension, attention distribution and situation processing skill.The present results show a correlation between CAT score and CRT total score, indicating that CRT total score places relative weights on speed of information processing and suppression of stereotypes, representing a very meaningful result.

Should Patients with Psychogenic Nonepileptic Seizures be Allowed to Drive?

“…Until further data are available, an individualized approach, as applied by 19% of respondents to our survey, is probably most appropriate. In our view, some restrictions in patients with PNES may be appropriate, with an individualized approach such as that advocated for epilepsy patients (28)(29)(30)(31). If restrictions are used in patients with PNES, they should use a short seizure-free interval of 1-3 months, because 3 months is the shortest for epilepsy in the United States.…”

Neurologic Conditions: Assessing Medical Fitness to Drive

“…Other factors associated with an increased risk include idiopathic cases, the presence of neurologic findings, and the duration since the previous seizure. 80 Seizures due to a known precipitating factor such as physical injury, vascular insult, or a metabolic or toxic disorder are unlikely to reoccur once the underlying factor is corrected. If the precipitating factor cannot be corrected, then consideration for initiating AEDs should be made.…”

Social Adjustment and Competence 35 Years After Onset of Childhood Epilepsy: A Prospective Controlled Study

“…Psychological and social problems may impair the quality of life of persons with epilepsy even more than do the seizures themselves (28). A major contributing factor may be restriction from driving, which has serious consequences in socialization, self-esteem, and employability (29)(30)(31).…”