Project Goal

This project examined the risk of seizure recurrence for individuals who have or have had unprovoked seizures, provoked seizures, a seizure caused by stroke, epilepsy, and surgery for epilepsy.

Background

A Federal Motor Carrier Safety Administration (FMCSA) regulation states in part that an individual is physically qualified to drive a commercial motor vehicle (CMV) in interstate commerce if the individual has “no established medical history or clinical diagnosis of epilepsy or any other condition which is likely to cause loss of consciousness or any loss of ability to control a commercial motor vehicle.” However, FMCSA issues exemptions from this regulation for select drivers who meet criteria based primarily on long periods of medical stability without a seizure.

Summary

Systematic reviews addressing seven key questions were completed. The seven key questions were:

1. What is the risk for seizure recurrence after an unprovoked first seizure at 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, and more than 10 years following the first seizure for individuals who (a) are treated with antiepileptic drugs, and (b) are not treated with antiepileptic drugs?
2. What is the risk for seizure recurrence after a provoked first seizure at 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, and more than 10 years following the first seizure for individuals who (a) are treated with antiepileptic drugs, and (b) are not treated with antiepileptic drugs?
3. What is the risk for seizure recurrence after a seizure caused by stroke at 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, and more than 10 years following the first seizure for individuals who (a) are treated with antiepileptic drugs, and (b) are not treated with antiepileptic drugs?
4. What is the risk for seizure recurrence after a diagnosis of epilepsy at 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, and more than 10 years following the diagnosis for individuals who (a) are treated with antiepileptic drugs, and (b) are not treated with antiepileptic drugs?
5. What is the risk for seizure recurrence for individuals who have undergone surgery for a structural brain abnormality or epilepsy at 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, and more than 10 years following the surgery?
6. What are the requirements for each State in the United States concerning seizures among commercial drivers? What are the driving requirements generally for select other countries?
7. What are the medical expert panel recommendations regarding seizures and driving for commercial drivers including (a) following a first unprovoked seizure, (b) following a first provoked seizure, (c) following a diagnosis of epilepsy, and (d) following a diagnosis of sleep epilepsy (defined as epilepsy with seizures only while asleep or upon awakening)?

Contractor

Applied Research Associates, Inc.

Final Report

The brief and report have been published in the National Transportation Library:

https://rosap.ntl.bts.gov/view/dot/67564

https://rosap.ntl.bts.gov/view/dot/67563