Makindo Medical Notes

Related Subjects: | First Seizure

If unsure, consult your seniors. When in doubt, advise patients not to drive and inform the DVLA. Do not discharge a patient who has had a seizure without appropriate advice and guidance.

Driver and Physician Responsibilities

• The driver is responsible for informing the DVLA of any medical conditions affecting their ability to drive.
• The doctor is responsible for advising patients that certain medical conditions and medications may impact their driving ability, and for informing them about which conditions must be reported to the DVLA.
• Drivers should also inform their insurance companies of any condition disclosed to the DVLA.
• AT A GLANCE GUIDE

Driving Guidelines for Group 1 Licence Holders (Car and Motorcycle)

Note: Group 2 licence holders (e.g., heavy vehicle drivers) are subject to stricter guidelines. See the DVLA "At a Glance" document for more details.

First Unprovoked Epileptic Seizure / Solitary Fit

• 6 months off driving from the date of the seizure unless clinical factors or investigation results suggest a high recurrence risk (≥20% per annum).

Epilepsy / Epileptic Seizures

• In cases where epilepsy is diagnosed, epilepsy regulations apply. This includes any single seizure attributed to a primary cerebral cause where recurrence cannot be excluded.
• Seizures related to acute head injury or intracranial surgery may be exceptions.

Cerebrovascular Disease: ischaemic and haemorrhagic, TIA, amaurosis fugax, and venous thrombosis.

• Must not drive for 1 month. Driving can resume if recovery is satisfactory and there are no residual neurological deficits.
• DVLA notification is only required if neurological deficits persist (e.g., visual, cognitive, or significant limb impairment).
• For multiple TIAs, a 3-month restriction may apply, and the DVLA should be notified.
• Seizures during a stroke/TIA or within 24 hours are considered provoked (no need to report unless other conditions apply).

Angina

• Driving must cease if symptoms occur at rest, with emotional distress, or while driving.
• May resume driving when symptoms are under control. DVLA notification is not required.

Acute Coronary Syndromes (ACS) unstable angina, non-STEMI, or STEMI

• Driving may resume after 1 week if successfully treated by coronary angioplasty, provided:
  • No further urgent revascularization is planned.
  • Left ventricular ejection fraction (LVEF) is ≥40% at discharge.
  • No other disqualifying conditions are present.
• For ACS not treated by angioplasty, driving may resume after 4 weeks if there are no other disqualifying conditions. DVLA notification is not required.

Simple Faint

• Provoked by identifiable factors with prodromal symptoms.
• Recurrences must meet the "3 P's" criteria (provocation, prodrome, postural) each time.
• No driving restrictions or DVLA notification required.

High-Risk Unexplained Syncope

• Defined by factors such as abnormal ECG, structural heart disease, or syncope causing injury or occurring while sitting/lying down.
• Can drive 4 weeks after event if cause is identified and treated.
• If no cause is identified, licence revoked for 6 months.

Low-Risk Unexplained Syncope

• No structural heart disease or abnormal ECG: Can drive 4 weeks after the event.