Page 491 - ILAE_Lectures_2015

Epilepsy is a ‘prescribed disability’, which means that an individual with epilepsy is barred
from holding a licence, unless the following criteria concerned with the control of seizures
are met:

Group 1 licences (motorcars, vans and motorcycles)

An applicant for a licence suffering from epilepsy shall satisfy the following conditions:

a. They shall have been free of any epileptic attack during the period of one year
immediately preceding the date when the licence is granted: or

b. Asleep seizures with no history of awake seizures. If the individual has only ever had
asleep seizures then once this pattern of only asleep seizures has been established for
one year, they can apply for a new Group 1 licence to drive, even if asleep seizures
continue. If awake seizures have occurred in the past, but seizures now only occur
during sleep, a licence is permitted if the applicant has had seizures only during sleep
for three or more years.

c. The driving of a vehicle is not likely to be a source of danger to the public.

d. Seizures which do not affect consciousness or ability to control a vehicle.

An individual can apply for a new Group 1 licence after one year of not driving,
even if they are still having seizures if all of the following apply:
 they stay fully conscious during the seizures
 they would be able to act, react, and control a vehicle normally during the

seizure
 they have only these types of seizures and no other type, and
 they have never had a seizure that affects consciousness or ability to control a

vehicle.

This liberalisation does not apply, therefore, to individuals who have had epilepsy
surgery for focal seizures with loss of awareness, and who continue to have auras
following surgery.

e. A driving licence is restored after six months if a seizure is precipitated by a
medically-advised drug change, if this change is reversed. The previously effective
medication needs to have been reinstated for at least six months. An exception to this
is a breakthrough seizure that does not affect consciousness or ability to drive, or that
is an asleep seizure (see above). The individual still needs to tell the DVLA about the
seizure, but may be allowed to drive and not lose their licence, depending on the type
of seizures they have had previously.

The following circumstances commonly arise:

Single unprovoked seizures. These are not considered as ‘epilepsy’ by the DVLA unless a
continuing liability can be demonstrated. The default for the licensing authority is to prohibit
driving for a 12-month period after the attack. Driving privileges, however, may be restored
after six months with the support of a neurologist and if MRI scan and EEG do not indicate
a high risk of seizure recurrence.

Provoked seizures. If a seizure is considered to be ‘provoked’ by an exceptional condition
which will not recur, epilepsy (defined as a condition with a continuing liability to seizures)