Patients with epilepsy who had a first seizure while driving a motor vehicle: a report of five cases_Journal of Epilepsy

Authors：

WANG Yan ¹ , WANG Pinchun ¹ , MA Xinnan ¹ , LU Yeting ¹ , ZHU Xiangyi ¹ , GAO Wei ² , XU Min ¹ , LI Yan ³ ,  HU Xiaowei ¹

1. Department of Neurology, the First Affiliated Hospital of Soochow University, Suzhou 215006, China;
2. Department of Neurosurgery, the First Affiliated Hospital of Soochow University, Suzhou 215006, China;
3. Department of Neurology, Children's Hospital of Soochow University, Suzhou 215006, China;

Corresponding?author：

HU Xiaowei, Email: huxiaowei@suda.edu.cn

Keywords：

Epilepsy; Driving; First Seizure

DOI：

10.7507/2096-0247.202410007

Video：

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Objective To preliminarily analyse the phenomenon of the first seizure in patients with epilepsy while driving a motor vehicle, and discuss its harms and possible coping strategies. Methods The first seizure while driving a motor vehicle was investigated among epilepsy patients who attended the First Affiliated Hospital of Soochow University from June 2020 to March 2023. Results A total of five patients had their first seizure while driving a motor vehicle, all causing traffic accidents. One patient had a generalized tonic-clonic seizure with a first epileptic seizure, two had focal seizures with impaired consciousness that progressed to generalized seizures, and two had focal seizures with impaired awareness. One of the patients caused a fatal traffic accident, leading to the death of another person who riding the electric bicycle. In this case, the patient's driving license was revoked. The other four patients continued to drive after the first seizure. One patient terminated driving 5 months after the diagnosis of epilepsy. Two patients drove less since then, and one patient continued driving as before. Two patients experienced seizures again while driving, and one of them coincidentally had his second seizure while driving. Conclusions The first seizure while driving may not be uncommon, reflecting the severity of epilepsy and driving, in which traffic accidents can be fatal. People with epilepsy are currently prohibited from driving in China. After the first seizure, patients should immediately stop driving and go to see an epileptologist, avoiding further endangering themselves and the public.

Citation： WANG Yan, WANG Pinchun, MA Xinnan, LU Yeting, ZHU Xiangyi, GAO Wei, XU Min, LI Yan, HU Xiaowei. Patients with epilepsy who had a first seizure while driving a motor vehicle: a report of five cases. Journal of Epilepsy, 2025, 11(1): 35-40. doi: 10.7507/2096-0247.202410007 Copy

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10.	Scheffer IE, Berkovic S, Capovilla G, et al. ILAE classification of the epilepsies: Position paper of the ILAE Commission for Classification and Terminology. Epilepsia, 2017, 58(4): 512-521.
11.	Commission E. Epilepsy and Driving in Europe. A report of the Second European Working Group on Epilepsy and Driving, an advisory board to the Driving Licence Committee of the European Union[R/OL]. [2023-02-04]. https://road-safety.transport.ec.europa.eu/system/files/2021-07/epilepsy_and_driving_in_europe_final_report_v2_en.pdf.
12.	Sheth SG, Krauss G, Krumholz A, et al. Mortality in epilepsy: driving fatalities vs other causes of death in patients with epilepsy. Neurology, 2004, 63(6): 1002-1007.
13.	Yang L, Morland TB, Schmits K, et al. A prospective study of loss of consciousness in epilepsy using virtual reality driving simulation and other video games. Epilepsy & Behavior, 2010, 18 (3): 238-246.
14.	Taylor J, Chadwick D, Johnson T. Risk of accidents in drivers with epilepsy. Journal of Neurology, Neurosurgery, and Psychiatry, 1996, 60(6): 621-627.
15.	Punia V, Farooque P, Chen W, et al. Epileptic auras and their role in driving safety in people with epilepsy. Epilepsia, 2015, 56(11): e182-e185.
16.	Li S, Chen J, Tong X, et al. Factors associated with seizure-related motor vehicle accidents among patients with epilepsy in West China. Seizure, 2019, 66: 42-46.
17.	Pohlmann-Eden B, Beghi E, Camfield C, et al. The first seizure and its management in adults and children. BMJ (Clinical Research ed.), 2006, 332(7537): 339-342.
18.	CCMTA. National Safety Code for Motor Carriers[S/OL]. [2023-02-11]. https://www.ccmta.ca/en/national-safety-code.

1. Thijs RD, Surges R, O'Brien TJ, et al. Epilepsy in adults. Lancet, 2019, 393(10172): 689-701.
2. 中華人民共和國公安部. 全國機動車保有量達4.35億輛駕駛人達5.23億人, 新能源汽車保有量超過2000萬輛[EB/OL]. [2024-10-15]. https://www.mps.gov.cn/n2254314/n6409334/c8837510/content.html.
3. 王怡青, 黃適存, 徐月娟, 等. 住院醫師對癲癇與駕駛認知和態度的問卷調查. 臨床神經病學雜志, 2019, 32 (02): 91-94.
4. 徐月娟, 胡小偉, 方琪. 癲癇與駕駛. 中華醫學雜志, 2018, 98(3): 231-233.
5. 胡小偉, 張敏, 王巖, 等. 國內外癲癇患者駕駛機動車的現狀分析臨床神經病學雜志, 2022, 35 (5): 395-398.
6. Chen J, Yan B, Lu H, et al. Driving among patients with epilepsy in West China. Epilepsy & Behavior, 2014, 33: 1-6.
7. 李佳音, 吉思媱, 王巖, 等. 7例未明確診斷患者癲癇樣發作致交通事故分析. 中華神經科雜志, 2023, 56 (5): 521-525.
8. Pohlmann-Eden B, Hynick N, Legg K. First seizure while driving (FSWD)--an underestimated phenomenon? Can J Neurol Sci, 2013, 40 (4): 540-545.
9. Fisher RS, Acevedo C, Arzimanoglou A, et al. ILAE official report: a practical clinical definition of epilepsy. Epilepsia, 2014, 55(4): 475-482.
10. Scheffer IE, Berkovic S, Capovilla G, et al. ILAE classification of the epilepsies: Position paper of the ILAE Commission for Classification and Terminology. Epilepsia, 2017, 58(4): 512-521.
11. Commission E. Epilepsy and Driving in Europe. A report of the Second European Working Group on Epilepsy and Driving, an advisory board to the Driving Licence Committee of the European Union[R/OL]. [2023-02-04]. https://road-safety.transport.ec.europa.eu/system/files/2021-07/epilepsy_and_driving_in_europe_final_report_v2_en.pdf.
12. Sheth SG, Krauss G, Krumholz A, et al. Mortality in epilepsy: driving fatalities vs other causes of death in patients with epilepsy. Neurology, 2004, 63(6): 1002-1007.
13. Yang L, Morland TB, Schmits K, et al. A prospective study of loss of consciousness in epilepsy using virtual reality driving simulation and other video games. Epilepsy & Behavior, 2010, 18 (3): 238-246.
14. Taylor J, Chadwick D, Johnson T. Risk of accidents in drivers with epilepsy. Journal of Neurology, Neurosurgery, and Psychiatry, 1996, 60(6): 621-627.
15. Punia V, Farooque P, Chen W, et al. Epileptic auras and their role in driving safety in people with epilepsy. Epilepsia, 2015, 56(11): e182-e185.
16. Li S, Chen J, Tong X, et al. Factors associated with seizure-related motor vehicle accidents among patients with epilepsy in West China. Seizure, 2019, 66: 42-46.
17. Pohlmann-Eden B, Beghi E, Camfield C, et al. The first seizure and its management in adults and children. BMJ (Clinical Research ed.), 2006, 332(7537): 339-342.
18. CCMTA. National Safety Code for Motor Carriers[S/OL]. [2023-02-11]. https://www.ccmta.ca/en/national-safety-code.

Journal of Epilepsy

Patients with epilepsy who had a first seizure while driving a motor vehicle: a report of five cases

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