Protecting Epileptics Behind the Wheel

Six states in the country require doctors to report any loss of consciousness during a seizure of one of their patients. While the law was designed to protect the public from car accidents caused by a loss of consciousness while driving, a new study finds it may lead patients to withhold information from their doctor about their medical condition. The finding was reported during the American Academy of Neurology Annual Meeting in Honolulu.

For the study, researchers surveyed more than 400 patients from the Stanford Epilepsy Clinic. California is one of the states with the mandatory reporting law. The survey replies were anonymous and 207 patients filled out the questionnaire. The patients were asked about their driving record, whether they had concealed medical information from their doctor, and how they felt the law affected their relationship with their doctor.

Researchers report almost half of the respondents were still driving and 77 percent of them had driven in the past. About 9 percent of the patients said they had concealed information on their seizures from their doctor due to fear of losing their driver’s license and 19 percent said they had considered concealing information from their doctor. This is dangerous because if doctors don’t know that their patients are having seizures, they can’t work with them to alter their medications to control their seizures.

The study also showed that 13 percent of the patients felt the mandatory reporting law had a negative impact on their relationship with their doctor. Our concern is that this will at least weaken the lines of communication between patient and doctor and at worse cause patients to go without treatment if they avoid medical care. Not only is this dangerous to the health of individual patients, but it also defeats the initial goal of the mandatory reporting law.

Interestingly, researchers also found four out of five patients said they would voluntarily stop driving if they had a seizure, whether or not the state had a mandatory physician reporting law. Researchers conclude policy makers should consider eliminating the mandatory law and replace it with a voluntary system.

Socioeconomic Status and Epilepsy

British investigators have linked epilepsy to socioeconomic factors.

In the British Medical Journal, researchers report people suffering the greatest socioeconomic disadvantages are significantly more likely to develop the condition than those suffering the least.

Health officials have long associated epilepsy with socioeconomic factors, noting people with the disease experience poor academic achievement, unemployment, underemployment, and low incomes. Investigators have also observed the condition is more common in developing than already developed countries. However, few studies have examined at the link between socioeconomic factors and the development of epilepsy in a community population.

Researchers determined the number of new cases of epilepsy in 20 physician practices in London and southeast England over an 18- or 24-month period. All patients in the practices were categorized for socioeconomic status using standard measures.

Nearly 200 new cases of epilepsy were identified during the period. Researchers then divided all the patients in the practices into five groups according to their scores on the socioeconomic measurement scale. The incidence of epilepsy was 2.3 times higher in the bottom fifth than in the top fifth.

Investigators don’t know why people who are disadvantaged are at higher risk of developing epilepsy, but suspect the higher rate of birth defects, trauma, infection, and poor nutrition seen in disadvantaged populations may play a role in the development of the disease.

Death From Epilepsy

Seizures can be a very frightening scene, especially when the victim is a child. Parents of epileptic children often worry about the child suddenly dying during a seizure. A new study offers reassurance to these parents.

A population-based study was conducted by researchers from IWK Health Centre in Canada. Researchers included data from all children who developed epilepsy from 1977 to 1985. They looked at the sex, age, epilepsy type and neurological disorders of the children who died. The information was then compared to information on children without epilepsy.

During the eight-year study, 26 of the 692 children with epilepsy died.

Researchers report 22 deaths were caused by neurological deficits, including aspiration with pneumonia, infection and heart failure. The other four deaths were caused by sudden unexpected death, suicide and homicide.

The study finds children with epilepsy have more than five times the risk of dying than the general population in the first 15 to 20 years of diagnosis. However, most deaths are related to neurological disorders. Therefore, researchers say if a child with epilepsy has no other serious disorder, their risk of death is very close to that of the general population.

Researchers hope this information will lift an enormous worry off the shoulders of families who care for a child with epilepsy.