Simulated driving in the epilepsy monitoring unit: Effects of seizure type, consciousness, and motor impairment. Issue 1 (24th November 2021)

• Record Type: Journal Article
• Authors: Kumar, Avisha; Martin, Reese; Chen, William; Bauerschmidt, Andrew; Youngblood, Mark W.; Cunningham, Courtney; Si, Yang; Ezeani, Cel; Kratochvil, Zachary; Bronen, Jared; Thomson, James; Riordan, Katherine; Yoo, Ji Yeoun; Shirka, Romina; Manganas, Louis; Krestel, Heinz; Hirsch, Lawrence J.; Blumenfeld, Hal
• Is Part Of: Epilepsia. Volume 63:Issue 1(2022)
• Page Start: e30
• Page End: e34
• Publication Date: 2021-11-24
• Subjects: consciousness -- driving simulation -- EEG -- epilepsy -- seizure -- tonic–clonic; Epilepsy -- Periodicals; 616.853
• DOI: 10.1111/epi.17136
• Languages: English
• ISSNs: 0013-9580

Abstract

Abstract: People with epilepsy face serious driving restrictions, determined using retrospective studies. To relate seizure characteristics to driving impairment, we aimed to study driving behavior during seizures with a simulator. Patients in the Yale New Haven Hospital undergoing video‐electroencephalographic monitoring used a laptop‐based driving simulator during ictal events. Driving function was evaluated by video review and analyzed in relation to seizure type, impairment of consciousness/responsiveness, or motor impairment during seizures. Fifty‐one seizures in 30 patients were studied. In terms of seizure type, we found that focal to bilateral tonic–clonic or myoclonic seizures (5/5) and focal seizures with impaired consciousness/responsiveness (11/11) always led to driving impairment; focal seizures with spared consciousness/responsiveness (0/10) and generalized nonmotor (generalized spike–wave bursts; 1/19) usually did not lead to driving impairment. Regardless of seizure type, we found that seizures with impaired consciousness (15/15) or with motor involvement (13/13) always led to impaired driving, but those with spared consciousness (0/20) or spared motor function (5/38) usually did not. These results suggest that seizure types with impaired consciousness/responsiveness and abnormal motor function contribute to impaired driving. Expanding this work in a larger cohort could further determine how results with a driving simulator may translate into real world driving safety.