Focal seizures during simulated driving: A pilot study

Cars are increasingly equipped with technology that can be used to analyze driver behavior and alertness, often referred to as driver monitoring systems (DMS). Although initially mainly used to track drivers' attention, DMS are now expanding in the hope of detecting additional forms of driver impairment that may jeopardize driving, such as drowsiness and those caused by sudden medical emergencies. To explore the potential for the latter, we conducted a pilot study to investigate whether technology in modern vehicles, such as eye tracking and driving behavior sensing, can detect abnormalities during seizures. We included 10 patients with focal epilepsy, all of whom had high seizure frequencies and a history of focal impaired awareness seizures. In three subjects, we recorded three definite and one possible electrographic seizure. All seizures were focal, with no motor features. We evaluated driving performance, saccade frequency, eye blink rate, and gaze direction. No clear impact of seizures on driving performance was observed, and eye-related measures showed inconsistent changes. Future studies should explore additional indicators and assess the potential to detect more severe seizures that may have a greater impact on driving performance.