Factors associated with seizure-related motor vehicle accidents among patients with epilepsy in West China

Abstract

This study was conducted to investigate the relevant demographics and clinical factors contributing to seizure-related motor vehicle accidents in west China. Methods: All driving patients who visited our epilepsy clinic in the West China Hospital, between October 2012 and October 2016, were invited to participate. Data on social demographics, clinical features, and motor vehicle accidents were collected during structured interviews. Binary logistic regression was used to identify factors associated with seizure-related motor vehicle accidents. Results: In total, 519 patients reported driving after being diagnosed with epilepsy. Among them, thirty-nine (7.5%) patients experienced at least one seizure-related motor vehicle accidents. Patients who had seizure-free intervals ≥2 years had a 89% reduced chance of crashing compared to patients with shorter intervals. Logistic regression revealed that the interval of seizure freedom (B = -0.384, P = 0.007), number of antiepileptic drugs (AEDs) taken (B = 0.400, P = 0.041), and type of motor vehicle (B = 0.798, P = 0.021) were independently associated with seizure-related motor vehicle accidents. Conclusion:The interval of seizure freedom, number of AEDs taken, and type of motor vehicle should be considered when counseling patients with epilepsy on driving. A longer seizure-free interval suggested a compromised risk of seizure-related motor vehicle accidents.

Individual prediction of motor vehicle accidents for patients with epilepsy

“…In this nomogram model, the seizure-free interval, seizure types, aura, whether seizures only occur nocturnally, age, and marriage are all factors related to traffic accidents. Our previous study showed that the frequency of seizure and seizure types can be risk factors for traffic accidents [12]. Our studies reached a similar conclusion (Frequency less than 1 year, RR 0.73) with a previous study [4,[19][20][21][22].…”

“…Few studies mention whether seizures only occur nocturnally. Li et al stated that seizure only at night might be a potential protective factor (10.3% vs 24.0%, p = 0.05) [12], although there was no prominent significant difference.…”

“…Therefore, we need to maintain a balance between patient safety and quality of life [11]. In 2019, our group published a study about the safety risk of PWE driving [12]. Based on that study, this paper included more cases, using a nomogram model to analyze and predict the safety risk of PWE driving.…”

Epilepsy and driving; Impact on the patient and the society

“…This was comparable to a Chinese study in 2019, where seizure freedom of more than 2 years was associated with an 89% reduced chance of a RTA. 6 Attempts have been made in the past to stratify driving risk based on levels of seizure related impairments. The common SLJoN ⏐ BOTEJU et al belief was that aura provided sufficient warning of a seizure.…”

“…4 Driving by those with epilepsy is reported from many non-Western countries as well. These include Saudi-Arabia 5 , China 6 , and India 7 , where the rates of RTAs are 27%, 7.5% and 7.8% respectively. A single previous study from Sri Lanka reported an accident rate of 15%.…”