Epilepsy and driving

The New Zealand Transport Agency | Waka Kotahi has guidelines for healthcare providers assessing fitness to drive for people with a range of conditions, including epilepsy.

If you have epilepsy, whether you’re allowed to drive, or how long you’ll need to stop driving for, depends on the type of epilepsy and the type of vehicle licence you have.

If you’ve recently had a seizure you should check with your healthcare provider before driving. This could be a nurse, nurse practitioner, GP or specialist.

Private drivers

If you’re a private driver (eg, you drive a car or motorcycle but you don’t earn a living from your driving) you can generally drive under the following conditions – check with your healthcare provider for further details.

• If you have controlled epilepsy: You can drive if you take suitable epilepsy medication and haven’t had a seizure for 12 months. This period may be reduced to 6 months after a review by a specialist and your usual healthcare provider who will assess whether you’re at low risk of having another seizure.
  
  
• If you have sleep epilepsy: You can drive if you have a stable pattern of sleep epilepsy – that is, you’ve had at least 2 years where you’ve only had seizures when you’re asleep or when waking up, and you haven’t had any seizures while you’re awake for the past 12 months.
  
  
• If you’ve had a single isolated seizure: This doesn’t necessarily mean you have epilepsy, but you’ll have to stop driving for 12 months. It may be possible to have this period reduced if:
  • you don’t have any more seizures for 6 months, and
  • there was a specific reason for the seizure that's not expected to occur again.
• This will be decided in consultation with a specialist and your usual healthcare provider.
  
  
• If you’re undergoing withdrawal of your anti-seizure medication: You shouldn’t drive while you’re reducing the dose of your medication and for 3 months after you’ve stopped it.
  
  
• If your epilepsy has been well controlled but you have a seizure while on treatment: You may be able to start driving again sooner than the full 6 to 12 month waiting period if:
  • the seizure happens after a long period of having no seizures (at least 12 months)
  • you know what triggered the seizure and can avoid that trigger
  • the triggering factor hasn’t caused previous seizures
  • you continue your seizure treatment
  • you have a minimum seizure-free period (this may be as short as 4 weeks in some cases where there is a known trigger).

Driving for work

The rules are stricter if you’re a commercial driver who earns a living from driving. Commercial drivers are those who have a heavy vehicle licence or a licence endorsement that involves passengers (eg, as a taxi driver).

You’re generally unfit to drive commercially if:

• you’ve had a seizure in the past 5 years
• you’re still on anti-seizure medication
• you don’t have support from a specialist saying your risk is extremely low.

You may be allowed to return to driving commercially if you have support from an epilepsy specialist and:

• you’ve been seizure-free for 5 years without medication, or
• you’ve been seizure-free for 10 years while still on medication.

You may need to have an EEG for a number of reasons, such as if you’re being tested for epilepsy, if surgery is being considered or if medication is being stopped.

You may be asked to have a sleep-deprived EEG, where you attend your appointment when you’re short of sleep. While there are no direct side effects from the EEG itself, you should be very careful until you’ve had a chance to sleep properly, as lack of sleep can make seizures more likely. Don't drive on the day of the test, and it’s recommended that someone stays with you for the rest of the day until you’ve had a chance to sleep properly.

• Stop driving and see your healthcare provider or neurologist if you:
  • have a seizure – even if it’s mild
  • have sleep epilepsy and suddenly have a seizure while you’re awake
  • change or stop your anti-seizure medication suddenly
  • have a seizure-related crash.
• In most cases, your healthcare provider will decide when you can safely return to driving and whether you need specialist support to make this decision.
• Once you’re able to drive again:
  • check that your insurance policies are valid and tell your insurer about your condition
  • tell your employer about your condition if your work involves driving.
• Take your anti-seizure medication as prescribed. Don’t skip doses.
• You’re more likely to have a seizure when you’re overtired or ill so avoid driving in these circumstances.
• Don’t drive sooner than 12 hours after even 1 alcoholic drink. There’s a danger period after drinking alcohol that’s greatest when your blood alcohol level has fallen to near zero. It isn’t safe to drive for 12 to 24 hours after moderate alcohol drinking, and even longer if you’ve had more to drink.