[Epilepsy and driving. Background, new German guidelines and comments]

The German guidelines for driving licenses concerning people with epilepsy or those who experienced single epileptic seizures have been revised. In cases of epilepsy a seizure-free period of 12 months is required for group 1 drivers (e.g. passenger cars). A seizure-free period of 5 years without antiepileptic drugs is mandatory for group 2 drivers (e.g. trucks) with epilepsy. A seizure-free interval of 3 months (group 1) or 6 months (group 2) is required after a single epileptic seizure caused by a plausible provocative factor. The guidelines stress that people who experienced a seizure induced by sleep deprivation may have a genetic disposition to generalized seizures. In such patients a complete electroencephalographic work-up is necessary before conclusions can be drawn. It is also emphasized in the guidelines that alcohol hardly ever is the key provocative factor for epileptic seizures. Advice concerning driving ability should only be given by a physician experienced in the diagnosis and treatment of epilepsy. Once a year a medical follow-up examination is required after driving capability has been approved.