TY - JOUR
T1 - Simulated driving in the epilepsy monitoring unit
T2 - Effects of seizure type, consciousness, and motor impairment
AU - Kumar, Avisha
AU - Martin, Reese
AU - Chen, William
AU - Bauerschmidt, Andrew
AU - Youngblood, Mark W.
AU - Cunningham, Courtney
AU - Si, Yang
AU - Ezeani, Cel
AU - Kratochvil, Zachary
AU - Bronen, Jared
AU - Thomson, James
AU - Riordan, Katherine
AU - Yoo, Ji Yeoun
AU - Shirka, Romina
AU - Manganas, Louis
AU - Krestel, Heinz
AU - Hirsch, Lawrence J.
AU - Blumenfeld, Hal
N1 - Publisher Copyright:
© 2021 International League Against Epilepsy
PY - 2022/1
Y1 - 2022/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85119679455&partnerID=8YFLogxK
U2 - 10.1111/epi.17136
DO - 10.1111/epi.17136
M3 - Article
C2 - 34816425
AN - SCOPUS:85119679455
SN - 0013-9580
VL - 63
SP - e30-e34
JO - Epilepsia
JF - Epilepsia
IS - 1
ER -