Should epileptics be allowed to drive?

By Meluse Kapatamoyo

Should epileptics be allowed to drive? That was the question onlookers at the scene of a recent accident in Lusaka asked as they stood by and watched a motorist who had had a seizure behind the wheel ram into another car.

The more conscientious among the bystanders helped him out of the car he was driving and laid him on the floor next to a hardware shop as he twitched and foamed at the mouth.

Thankfully, no –one was injured in the accident and the driver of the care he had hit into made a compassionate decision not to press charges.

But his decision did not absolve the epileptic motorist from blame for driving when the unpredictability of his condition posed a risk to him and a greater risk to motorists and pedestrians alike.

But Epilepsy Association of Zambia president Anthony Zimba has a different point of view about whether or not those who suffer seizures should be licensed to drive.

EAZ President Anthony Zimba

He says frequency of the seizures, epileptic or non- epileptic, what time they come and whether the patient is on medication or not, determines whether the patient should get behind the wheel. 

“If someone has active seizures, meaning they are frequent and come during the day and that person is on medication, such people are not supposed to drive. But if the seizures only come at night, we may have a discretion and allow that person to drive,” he explained.

People, whose seizures are irregular and only come once a year or once every six months, can also be given a go-ahead by medical practitioners to get on the road. But, they can only drive light vehicles and not passenger vehicles such as mini-buses or trucks.

People with irregular seizures and not on medication, should not drive.



RTSA has recorded 600 deaths in the third quarter of 2012

However, while these precautions can mean life or death, for the driver and other road users, these are not laws. Health practitioners can only advice. The final decision is with the patient who has the right to decide whether to drive or not. Unfortunately, many get on the road.

Mr Zimba said, “If there were regulations, which we do not have in this country, in a situation as the one at Millennium Bus stop, if it’s confirmed epilepsy, that persons licence can be suspended until such a time when the seizures have stopped completely and they have been on treatment for two and half years. Only then can their licence be lifted. With any laws, all we can do is for now is plead with our patients not to drive, some do, but because the majority of people hide their condition even from employers, they end up driving.”

Zambia is one of the many countries in Africa that have no regulations for persons with epilepsy or seizures. But, countries like South Africa have formulated some guidelines.

According to the South African National Road Traffic Act, you are not permitted to drive if you have uncontrolled epilepsy. Nonetheless, they too have left the final decision of whether to drive or not to the individual concerned and their health doctor.

In addition, Epilepsy South Africa, has formulated the following guidelines for people with epilepsy; if you change or stop your medication suddenly, stop driving until your doctor advises it’s safe to do so. If you have a seizure for the first time in years, stop driving and consult your doctor. Don’t drive when you’re tired, stressed or ill, as you’re more likely to have a seizure at such time. Never drink and drive.

Unfortunately, ‘epilepsy can happen anywhere and at anytime,’ early this year, a man was killed when he crashed into a primary school in SAs Cape Town, apparently while suffering an epileptic seizure. Two children were also injured.

The incident drew a lot of national interest, with condolence messages going to the deceased family and speedy recovery messages to the two kids who were injured. Concerns were also raised as to whether the man should have been driving given his condition.

In the United Kingdom, the Driver and Vehicle Licensing Agency (DVLA) is the condition that licenses cars and drivers for driving on public roads. Its guidelines say if you have a driving licence, by law it is your duty to tell the DVLA about any medical condition which may affect your ability to drive, including epilepsy. This is a condition of holding a driving licence.

According to the Epilepsy Society, “if you have a driving licence, and have a seizure of any kind, the DVLA regulations say that you must stop driving. You are responsible for telling the DVLA and returning your licence to them.

“The regulations cover all epileptic seizures: auras and warning, seizures where you are conscious, myoclonic jerks, and seizures where you lose consciousness.”

In Zambia, every expectant driver must conduct a medical test for audio and visual capacities, where obvious disabilities are also noted, Road Traffic and Safety Agency (RTSA) Principal Publicity Officer says, “Problems such as epileptics cannot be diagnosed, unless the person reveals on their own that they suffer from this condition. And then evidently RTSA would not give a license because such a disease is not planned for any attack.”

Conducting drivers test involves a theoretical test that requires knowledge o the Highway Code involves a practical test that requires ones skills such as reversing, turning right, left and simply propelling the vehicles. Road skills such as getting into the reality of driving where there is traffic are also conducted with a RTSA examiner.

“I am not sure what type of machines can determine someone's driving skills except to have tests that take the drivers on the road and they are practically tested by examiners. RTSA has never recorded or received any reports of seizures as causes of accidents on the road,” said Khozi.

The agency recorded 8, 801 accidents, in the third quarter of 2012, that  led to 600 deaths.PYM