Epigraph Vol. 12 Issue 3, Summer 2010
New European Regulations for Driving and Epilepsy Come Into Force in August 2010
With the imminent accession of a large number of Central and Eastern European countries into the European Union (EU), the European Commission of the EU set up three working groups to review driving regulations in 2003. The specific groups were for Diabetes, Epilepsy and Eyesight. It is understood that there were concerns that many of the accession countries had no driving regulations for these conditions or operated blanket bans. In both these circumstances many people with the conditions drive because of the perceived unfairness of this. EU officials undoubtedly had visions of many Heavy Goods Vehicle (HGV) drivers who might be unfit to drive, undertaking huge journeys across the European land mass.
The epilepsy and driving working group was headed up by Dr Eric Schmedding, a Belgian Neurologist with particular expertise in this area. The other members of the group were also epileptologists drawn from all over Europe many of whom had been members of the earlier Driving and Epilepsy Workshops held in the late nineties in Brussels led by the late Dr Arthur Sonnen.
The Schmedding group brought in its final report with proposals to unify driving and epilepsy regulations across Europe in less than two years. It has taken more than five years for the proposals to be accepted by the EU but it is hoped that by the end of August 2010 the new regulations will be in place in all member states.
The EU European Directive 209 / 112 EC came into law on 29 August 2009.This Directive puts into force the recommendations on Epilepsy and Driving of the expert working group led by Dr Eric Schmedding which reported to the European Commission in 2005. European Union member states have up to one year to introduce new legislation or amend existing driving regulations in line with the Directive. In other words, EU member states must comply with this Directive by 29 August 2010.
Different rules apply for many other situations such as seizures in sleep, loss of consciousness, provoked seizures etc. but only the main points of the regulations are listed below \for full details please go to the IBE Driving Task Force pages.
The Directive defines Epilepsy as follows:
Epilepsy is defined as having had two or more epileptic seizures less than five years apart. A provoked epileptic seizure is defined as a seizure which has a recognizable causative factor that is avoidable;
and refers to First Seizures in this way:
an initial or isolated seizure or loss of consciousness should be advised not to drive. A specialist report is required, stating the period of driving prohibition and the requested follow-up.
It is extremely important that the person's specific epilepsy syndrome and seizure type are identified so that a proper evaluation of the person’s driving safety can be undertaken (including the risk of further seizures) and the appropriate therapy instituted. This should be done by a neurologist.
Group 1 Rules (cars, vans, motorcycles, etc):
Drivers assessed under group 1 with epilepsy should be under license review until they have been seizure-free for at least five years.
If the person has epilepsy, the criteria for an unconditional license are not met. Notification should be given to the Licensing Authority.
Epilepsy: Drivers or applicants can be declared fit to drive after a one-year period free of further seizures.
First or single unprovoked seizure: the applicant who has had a first unprovoked epileptic seizure can be declared able to drive after a period of six months without seizures, if there has been an appropriate medical assessment. National authorities may allow drivers with recognized good prognostic indicators to drive sooner.
Group 2 Rules (Buses, Trucks, HGVs, etc)
The applicant should be without antiepileptic medication for the required period of seizure freedom. An appropriate medical follow-up has been done. On extensive neurological investigation, no relevant cerebral pathology was established and there is no epileptiform activity on the electroencephalogram (EEG). An EEG and an appropriate neurological assessment should be performed after the acute episode.
Epilepsy: Ten years freedom from further seizures shall have been achieved without the aid of antiepileptic drugs. National authorities may allow drivers with recognized good prognostic indicators to drive sooner. This also applies in case of "juvenile epilepsy."
First or single unprovoked seizure: The applicant who has had a first unprovoked epileptic seizure can be declared able to drive once five years' freedom from further seizures has been achieved without the aid of antiepileptic drugs, if there has been an appropriate neurological assessment. National authorities may allow drivers with recognized good prognostic indicators to drive sooner.
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