Can People With Epilepsy Drive?
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Medically reviewed by Huma Sheikh, MD
Whether you can drive with epilepsy depends on your specific diagnosis, treatment, and the laws in your state. Epilepsy is a neurological condition that results in seizures. Because seizures can come on unpredictably and without warning and cause involuntary behaviors including loss of consciousness, driving when you have epilepsy poses some risks.
This article explains driving laws by state, how to get and keep your driver's license when you have epilepsy, and how seizure medication impacts driving.
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Can People With Epilepsy Drive?
Your driving privileges may change when you receive an epilepsy diagnosis. According to the Epilepsy Foundation, these regulations vary by state. Restrictions usually involve:
Being seizure-free for a certain period (as short as three months to as long as one year)
A physician's evaluation of a person's ability to drive safely
Submitting periodic medical reports
Some states may allow you to drive with epilepsy under certain restrictions. For example, you might be allowed to drive only during the day, to and from work, or during an emergency.
If your seizures only occur during sleep, do not involve loss of consciousness, and you have warning signs (like an aura, for which you have a sensory experience before your seizure), you might be a candidate for a restricted license.
The inability to drive or restrictions on driving are significant difficulties for many people, especially those who do not have access to adequate public transportation. For example, a 2019 study published in Neuroepidemiology found that up to 39% of people with epilepsy drove in violation of restrictions.
Getting and Keeping Your License With Epilepsy
If you have epilepsy and are applying for a license for the first time or trying to reinstate your license, you will have to jump through some extra hoops. These requirements vary by state.
Licensing
When you apply for a license, most states will ask questions about your health that could impact your ability to drive safely. These may include questions about whether you have ever experienced a loss of consciousness or voluntary movement. If you have epilepsy, you must disclose this information when applying for a license.
Having epilepsy does not necessarily mean you can't obtain a driver's license. That depends on your state's rules and whether you can drive safely without the risk of injuring yourself or other people. States will often require a medical exam and a report from a physician stating that your condition is under control and that they believe you can safely operate a motor vehicle.
Many states require a person to be seizure-free for a certain period before they may have a driver's license. This period varies by state—commonly, ranges are three months, six months, or one year. Some states do not have a defined seizure-free period. Instead, they evaluate applicants on a case-by-case basis.
Review and Decision Process
In most states, decisions about whether to issue a driver's license rest with the state's department of motor vehicles or the secretary of state. Sometimes, a state's medical advisory board will evaluate the situation and make a decision. Usually, there are appeals processes in place in case you disagree with their decision.
In addition, specific modifiers may favorably impact decisions about licensure. For example, in some states, the following situations may allow you to get your license sooner or obtain a restricted or probationary license:
Seizures do not interfere with motor control.
You have prolonged auras (allowing enough warning time to stop driving).
Seizures only occur while sleeping.
You have a favorable driving record.
Your seizures occurred as a result of a change in medication.
Related: An Overview of Level of Consciousness (LOC)
Mandatory Reporting Laws
Not all states require that physicians report people with epilepsy, but some do. Physicians may be fined for failing to report in states requiring reporting. In addition, they may be charged in a lawsuit if an accident results. States that require reporting include:
California
Delaware
Nevada
New Jersey
Oregon
Pennsylvania
The impetus behind mandatory reporting is to keep you and other people safe. But reporting is generally a sticky situation because it compromises the doctor-patient relationship.
Sometimes, this can result in an even riskier situation—a person may hide their symptoms from their healthcare provider to prevent reporting, thereby not receiving adequate treatment and increasing the likelihood that they will experience a seizure.
Personal Liability
In addition to state requirements, if you have epilepsy, it's important to consider your personal liability while driving. For example, you could be held civilly or criminally liable if you drive against medical advice, without a license, or if you withhold information about seizures from the department of motor vehicles.
Maintaining Your License
Your state will likely require annual reporting to maintain your license when you have epilepsy. This often involves obtaining a note from your healthcare provider stating your seizure history and their opinion on whether you can drive safely.
After a certain seizure-free period, most states will no longer require ongoing reporting to maintain your license. This period is usually between three and five years.
Does Seizure Medication Impact Your Driving Ability?
Anti-epileptic drugs (AEDs), also called anti-seizure medications or anticonvulsants, are prescription medications that prevent seizures. AEDs have potential side effects that could impact driving, including:
Vision problems
Balance
Memory
Reaction time
Attention
According to a 2018 study of more than 29,000 people with epilepsy in Sweden, the authors found that those with epilepsy were about 30% more likely to crash their car than those without it. However, the fatal car crash rate was less than 0.1%.
The most important finding of this study is that AEDs did not appear to play a significant role in crashes with people with epilepsy requiring medical attention.
Other research has also found that people on AEDs do not have statistically significant driving differences from those who don't have seizures.
For example, a 2021 study in Seizure evaluated the driving performance of people with epilepsy who took AEDs for their condition and compared them to a healthy control group. Researchers found that their driving performance was not different from that of the control group.
Summary
Having epilepsy doesn't necessarily mean you can't drive. Whether you can obtain a driver's license depends on the laws in your state and factors like whether your seizures interfere with motor control, are preceded by warning signs (auras), or only occur at certain times (like sleep).
Many states require annual reporting from a physician to maintain your license. If you've been seizure-free for a certain amount of time, you may be able to forgo the reporting requirement.
Frequently Asked Questions
Are certain types of seizures more dangerous to drive with?
Certain seizures are more dangerous for driving. For example, if your seizures are unpredictable, do not have a warning signal (aura), and are not managed by medication, it may be more dangerous for you to drive.
Do drivers with epilepsy get into more accidents?
Though some research indicates a moderate to no increase in car accidents in people with epilepsy, other research suggests an accident rate of 1.13–2.16 times that of healthy subjects.
Overall, driving restrictions have eased over the years because epilepsy can be controlled with AEDs and because well-controlled epilepsy does not pose an extraordinary risk to traffic safety compared to other risk factors, such as age and other medical conditions.
Can driving trigger a seizure?
If you have photosensitive epilepsy, certain visual stimuli during driving could trigger a seizure. For example, bright sunlight reflection or flashing lights on emergency vehicles may be a trigger while driving for some people.
