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outweigh the needs of medical confidentiality. It is sensible to inform the medical indemnity
organisation and the GMC that you are taking this course and the reasons for your decision.

Withdrawal of AED on medical advice. From a medico-legal point of view, the risk of further
epileptic seizures occurring during this therapeutic procedure should be noted. If an epileptic
seizure does occur, the patient will need to satisfy driving licence regulations before resuming
driving and will need to be advised accordingly.

It is recognised that AED withdrawal is associated with an increased risk of seizure
recurrence. A number of studies have shown this, including the Medical Research Council
Anti-epileptic Drug Withdrawal Study Group that found a 40% risk of seizure recurrence on
withdrawal of medication.

The Secretary of State's Honorary Medical Advisory Panel on Driving and Disorders of the
Nervous System has recommended that patients should be warned of the risk they run, both
of losing their driving licence and also of having a seizure which could result in a road traffic
accident. The Panel advises that patients should be advised not to drive from commencement
of the period of withdrawal and thereafter for a period of six months after cessation of
treatment.

Group 2 licences (lorries larger than 3.5 tonnes and passenger carrying vehicles of nine
seats or more for hire or reward)

An applicant for a licence shall satisfy the following conditions:
a. No epileptic attacks have occurred in the preceding ten years and that the individual has

taken no AED treatment during this period.
b. There is no continuing liability to epileptic seizures.

The purpose of the second condition is to exclude persons from driving (whether or not
epileptic seizures have actually occurred in the past) who have a potentially epileptogenic
cerebral lesion or who have had a craniotomy or complicated head injury, for instance.

If a Group 2 licence holder has an episode of loss of awareness of uncertain cause, but which
is not diagnosed as being due to epilepsy, their licence will be suspended for five years.

After an isolated epileptic seizure a Group 2 licence is suspended, and may be reinstated after
five years if no AEDs have been taken to control epilepsy.

The Secretary of State may require an appropriate medical assessment by a neurologist; and
be satisfied that the driving of a vehicle by the applicant, in accordance with the licence, is
not likely to be a source of danger to the public.

Taxis, ambulances or emergency service vehicles
The DVLA does not issue licences for taxis, ambulances or emergency service vehicles. It is
recommended that Group 2 medical standards should be applied.

References

1. VAN DER LUGT, P.J.M. (1975) Traffic accidents caused by epilepsy. Epilepsia 16, 747-751.
2. TAYLOR, J.F. (1983) Epilepsy and other causes of collapse at the wheel. In: Driving and Epilepsy and Other

Causes of Impaired Consciousness, Royal Society of Medicine International Congress and Symposium Series,
Vol 60, R.B. Godwin-Austin and M.L. Espir (Eds). Royal Society of Medicine, London.
3. PARSONS, M. (1986) Fits and other causes of loss of consciousness while driving. Q. J. Med. 58, 295-304.
4. HANSOTIA, P. and BROSTE, S.K. (1991) The effect of epilepsy or diabetes mellitus on the risk of automobile
accidents. N. Engl. J. Med. 324, 22-26.
5. HANSOTIA, P., BROSTE, S.K. (1993) Epilepsy and traffic safety. Epilepsia 34, 852-858.