AAN Issues a Revised Position Statement on Seizures and Driving

The American Academy of Neurology (AAN), in collaboration with the American Epilepsy Society (AES) and the Epilepsy Foundation of America (EFA), released an updated position statement on licensing drivers who experience seizures. The consensus statement revises earlier guidelines from 1994 and 2007.

The statement calls for establishing national licensing criteria—developed by medical advisory boards and informed by evidence-based recommendations—in order to reduce confusion and improve compliance among individuals with seizures and their health care providers. In the absence of national criteria, medical advisory boards should work with state departments of motor vehicles to set regulations.

The statement recommends the following medical criteria for any national or state guidelines:

• Instituting a minimum 3-month seizure-free interval before driving can resume after a seizure, with possible extensions determined by medical advisory boards following individualized case assessments.
• Waiving the minimum seizure-free interval for individuals with provoked seizures that are unlikely to recur or for previously stable patients who experience seizures resulting from short-term medication interruptions under medical supervision.
• Suspending driving during medication tapering or discontinuation unless replaced with alternative treatment.
• Refraining from driving when seizure medications impair cognition or coordination.

The statement also addresses medical reporting responsibilities, recommending that health care providers be allowed—but not required—to report patients who may pose increased driving risks. Providers should be protected from legal liability, regardless of whether they choose to report, since mandatory reporting has proven ineffective in reducing motor vehicle accidents and may lead patients to drive without a license or withhold information from their providers.

The consensus statement underscores the importance of medical advisory boards and health care providers in balancing public safety with patients’ rights and quality of life. It also urges governments to provide alternative transportation options for individuals restricted from driving due to seizures.