Anticonvulsant drugs and advice about driving after head injury and intracranial surgery

Abstract

In 1976 driving licences in the United Kingdom became valid until the driver is aged 70. Since then drivers have had a statutory duty to report both relevant and prospective disabilities - conditions that might affect their fitness to drive. Epilepsy is a relevant disability which is, however, compatible with holding an ordinary driving licence under certain conditions that mainly relate to a stipulated period of freedom from attacks. The risk that epilepsy may begin after a head injury or craniotomy may constitute a prospective disability. Patients whose licence is revoked even temporarily in such circumstances, however, may be very resentful; their surgeons often share this resentment and will sometimes support an appeal against the Driving Vehicle Licensing Centre. The surgeon then usually states that the risk of epilepsy in the patient is minimal, yet it often transpires that he has prescribed prophylactic anticonvulsant drugs. This paper reports the results of a survey of current practice among a sample of British neurosurgeons in respect of prescribing anticonvulsant drugs and advice about driving.