x Abu Dhabi, UAE Thursday 20 July 2017

Epilepsy on the road

An award-winning neurologist says authorities in the UAE need to provide clear guidelines and regulations for drivers who suffer from epilepsy.

A Dubai medical expert says drivers who suffer from epilepsy should have regular EEG checkups to monitor their condition.
A Dubai medical expert says drivers who suffer from epilepsy should have regular EEG checkups to monitor their condition.

Authorities in the UAE need to provide clear guidelines and regulations for drivers who suffer from epilepsy, says award-winning neurologist Dr Arne Brosig from the German Center for Neurology and Psychiatry in Dubai Healthcare City. Many countries have controls in place to prevent epilepsy-related accidents. However, the UAE has no restrictions or public guidelines for people prone to epileptic seizures.

Epilepsy is a serious and endangering condition that manifests itself in different ways, according to Brosig: "Epilepsy often displays itself in the sudden occurrence of fits. "Very often this leads to a serious disturbance or even complete loss of consciousness. Even small epileptic fits whereby consciousness isn't lost may severely impair the ability to drive. Such fits can cause vision disturbance or cramps, which can have dire consequences for driver, passengers and others."

The most recent UAE study came from the Department of Community Medicine and Family Medicine at United Arab Emirates University in Al Ain. It was carried out between October 1992 and June 1994. The aim of the paper was to investigate the risk and effect of epilepsy on road traffic accidents and casualties and identify possible risk factors for traffic accidents and violations among epileptic drivers. From these drivers, 34 per cent had at least one epileptic seizure per year and 26 per cent had at least one seizure per month.

The most common violations were careless driving (34 per cent) and traffic regulation violations (24 per cent). A significantly higher risk was observed from epilepsy sufferers with regard to property damage and traffic violations. Almost 50 per cent of the subjects had a full licence to drive private or commercial taxis. The study concluded that patients with conditions such as epilepsy should feel obliged to inform the traffic authorities or the health authorities about their condition. It claimed incidents could be greatly reduced if appropriate action was taken concerning epileptic drivers and made these recommendations to UAE traffic and health authorities at the time.

Dr Brosig said: "People with epilepsy should be allowed to drive, but only under certain conditions, and the rules should be clear and strictly enforced. There should also be clear guidelines for UAE drivers diagnosed with the condition of epilepsy in the UAE. "For instance, in the UK you can apply or reapply for a licence as long as you have been completely free from epileptic seizures for one year. This is only granted if the driving agency is satisfied that as a driver you are not likely to be a source of danger to the public."

Dr Brosig also added that, under certain conditions, an accident due to a known but concealed diagnosis of epilepsy might lead to the loss of insurance coverage. Dubai Road Transport Authority's licensing director, Ali Al Jassim, explained that Dubai's Licensing Agency has had discussion with Dubai Police as well as the Dubai Health Authority on this subject. "If the person with the illness epilepsy is detected during the training period before licensing, the issue is reported to the Dubai licensing authorities. The licensing authority then refers the person to the Dubai health authorities for proper medical evaluation. Driving students will be required to submit a relevant medical report where appropriate actions will be taken based on the recommendations of the medical report.

"If epilepsy is detected after the licence has been issued, such as due to involvement in an accident, Dubai Police will refer the issue to the Dubai health authorities and the licensing authorities will be notified. The licensing authority may decide to take necessary and appropriate actions with regard to the person's driver's licence if the medical report shows evidence of such illness as epilepsy," he said.

When asked whether the Dubai Licensing Agency plans to make guidelines for epilepsy sufferers public, Al Jassim explained: "I believe this issue requires a comprehensive study and there is a plan to conduct a dedicated project, which will include the proper guidelines, among other things. Once this is completed, information will be made available on the web site." In the UK, anyone who suffers even a minor epileptic seizure has to inform the vehicle licensing authorities, who will suspend the licence for at least a year. The patients can then reapply for their licence after twelve months provided they remain seizure-free over that period. The effects of this can be severe, especially if they have a job which requires driving. Therefore it is thought that many epileptics are prepared to run the risk of a subsequent epileptic seizure while driving, rather than inform the Licensing Authority.

To obtain a driver's license in most US states, a person with epilepsy must be free of seizures for a certain period of time, usually a year, and may be required to submit a doctor's statement that the person can drive safely. A recent US conference of epilepsy organisations recommended a seizure-free period of three months for driving privileges, since surveys had found that returning to driving after three months rather than a year did not greatly increase the rate of seizure-related crashes.

In Australia a, person with epilepsy cannot hold an unconditional license, but a conditional licence may be granted by the authorities for three or six months after seizure-free periods set by experienced epilepsy consultants and are subject to at least an annual review. There is still some debate over whether a ban is medically required and the duration of such a ban. Researchers from the Mayo Clinic in Maryland in the US were given the opportunity to test this question when the state of Arizona decided to reduce the length of the prohibition from a year to three months. The team looked at the number of seizure-related crashes before and after the change and found here was a small increase in such incidents with eleven more seizure-related crashes.

Dr Brosig said: "Those experiencing epilepsy should be treated as soon as possible with special anti-epileptic drugs combined with regular EEG checkups, thus saving many other connected problems. "Few traffic accidents turn out to be harmless. More often serious injuries are caused which may have lasting consequences or even have a deadly outcome. Therefore it is crucial UAE authorities monitor this correctly and epilepsy sufferers themselves seek professional advice when it comes to driving." motoring@thenational.ae