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is not deemed to be present. Driving is usually allowed once the provoking factor has been
successfully or appropriately treated, and provided that a ‘continuing liability’ to seizures is
not also present. These cases are treated on an individual basis by the DVLA. A cautious
attitude to ‘provocation’ is taken, however, and the provoking factor must be exceptional.
Seizures related to alcohol or illicit drugs are not considered ‘provoked’.

In the absence of any previous seizure history or previous cerebral pathology, the following
seizures may also be regarded as provoked:

 eclamptic seizures
 reflex anoxic seizures
 an immediate seizure at the time of a head injury
 seizure in first week following a head injury
 at the time of a stroke/TIA or within the ensuing 24 hours
 during intracranial surgery or in the ensuing 24 hours

Seizures occurring during an acute exacerbation of multiple sclerosis or migraine will be
assessed on an individual basis by DVLA.

Electroencephalographic changes. Although EEG can provide useful confirmation of
epilepsy and its type, the diagnosis of epilepsy is essentially clinical. Episodes of 3 Hz
spike/wave discharges in idiopathic generalised epilepsy and electrographic seizures are not
a bar to driving if there is no clinical accompaniment.

Neurosurgery. When epileptic seizures occur following neurosurgery, the epilepsy
regulations must be applied. An exception can be made when seizures occur at the time of
surgery. Following intracranial surgery, even if seizures have not occurred, driving is usually
prohibited for a period which varies according to the type of underlying pathology, and the
nature and site of the neurosurgery. The duration of the period of restriction is based on the
risk of seizures.

Cerebral lesions. When certain cerebral lesions are demonstrated, a single seizure is
considered to be epilepsy (on the basis that a continuing liability to seizures is present). In
the following conditions, even when epilepsy has not occurred, restrictions are applied
because of the known risk of epilepsy: malignant brain tumours, cerebrovascular disease,
serious head injury, intracranial haemorrhage and cerebral infection. The duration of the
period of restriction is based on the risks of seizures developing.

Treatment status. The epilepsy regulations apply whether or not the patient is receiving
antepileptic drugs (AEDs). Starting, or changing, AED treatment does not influence a
decision about licensing. If antiepileptic medication is being completely withdrawn in a
person with epilepsy who has been seizure free for some years and who has a Group 1 licence,
the DVLA recommend that the individual does not drive during the tapering of the AED or
the subsequent six months, as this is the period with the highest risk of seizure recurrence.

Obligations. There is a legal obligation for the individual with epilepsy to inform the DVLA
about their condition. This is the case regardless of clinical or domestic circumstances or
extenuating factors. The obligation on the doctor is to inform the patient about the regulations
and their requirement to inform the DVLA. This instruction should be recorded in the medical
notes, to avoid claims of negligence.

If an individual is known to be continuing to drive it is recommended to repeat the advice in
the presence of their relatives, and to point out that their insurance policy would be invalid.
If that individual is known to be continuing to drive it is appropriate to inform the DVLA,
and advisable to tell the individual that you are doing this as the needs of public safety