The cumulative incidence of epilepsy is at least 4% of the population. The prevalence of active epilepsy in the adult population is 4 to 10 in 1000 people (Hauser et al. 1996; Goodridge et al. 1983). For the European union we assumed a value of 6 in 1000. Of these patients, a substantial number hold a drivers licence (Sonnen 1995). In general, driving is experienced as one of the top concerns of people with epilepsy, as is noticeable in the daily practice of any neurologist. In surveys, driving is listed as a first or second concern by people with epilepsy, after the wish to be seizure-free (Gilliam et al. 1997; Taylor et al. 2001; Fisher et al. 2000). On the other hand, driving while having active epilepsy clearly poses an increased risk, ( Krauss et al. 1999; Berg et al. 2000) while drivers with epilepsy who are in compliance with driving restrictions and with medication intake pose no excess danger (Krauss 1999). This makes the topic of “epilepsy and driving” of importance to neurologists and the regulators of driver licensing alike. In the European Union, the regulations about driver licensing used to differ greatly among member states. (Fisher et al 1994) With the support of the European government, this led to the formation of European workshops on driving licence regulations in May 1995 and March 1996 organised by the International League against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE)(Sonnen 1995 and 1997). The recommendations of these workshops were not reflected in an official European guideline or in European law. In these recommendations, as well as in an American consensus statement, control or remission of seizures, measured as the “seizure-free interval” is the main determinant in the assessment of the ability to drive (Sonnen 1997, Krumholz 1994) and it will be the subject of a large part of this report.(Author/publisher)
Abstract