OBJECTIVE--To estimate the risks of road traffic accidents over a period of three years in drivers with a history of single seizures or epilepsy, and to compare them with a cohort of drivers followed up by the Transport Research Laboratory (TRL). DESIGN--A retrospective survey of driving and accident experience by self-completion questionnaire. SUBJECTS--16,958 drivers with a previous history of epilepsy responding to the survey and 8888 non-epileptic drivers responding to a TRL survey. MAIN OUTCOME MEASURES--The risk of any accident, any accident producing an injury, and any accident producing a serious injury, over a three year period. RESULTS--After adjustment for differences in age, sex, driving experience, and mileage between the two populations there was no evidence of any overall increase in risk of accidents in the population of drivers with a history of epilepsy. However, there was evidence of an increased risk of more severe accidents in the population with epilepsy. The risk was increased by about 40% for serious injuries and there was evidence of a twofold risk of increase in non-driver fatalities. These increases seem largely explicable by the occurrence of seizures in this population during the three years of driving that the survey covered. CONCLUSIONS--The acceptability of driving for people with a history of epilepsy should be determined by an acceptable risk of accidents resulting in injury or serious injury rather than overall accident rates. As people with epilepsy can now drive after a 12 month seizure free period rather than the required two year period when this survey was undertaken, it is important to ascertain whether there is any increased risk of injury associated accidents with this policy.
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