Implications for driving based on the risk of seizures after ischaemic stroke

 Your risk of seizures here:

• 10% seizures post stroke (19 posts to April 2017)

• 5% epileptic seizures after stroke (10 posts to April 2021)

• epileptic seizures (6 posts to December 2015)

• post-stroke epilepsy (7 posts to December 2016)

 I thought the driving simulator was worthless.

My return to driving was with an occupational therapist; Drive right now with no practice and see if you pass, almost guaranteed for 90+% to fail. And since they never pulled my license I just started driving after having to buy a new automatic transmission car.

You don't want this to happen so ask your doctor for EXACT STROKE PROTOCOLS TO RETURN TO DRIVING.  Maybe even better don't ask about this because then your doctor might remember to pull your license.

Health goes downhill when older adults stop driving

Maybe your doctor can look at these and actually help you get back to driving.

Predicting road test performance in drivers with stroke

Stroke survivor, researchers encourage patients to discuss driving with their doctors

Stroke survivors more likely to make dangerous driving errors

 The latest here:

Implications for driving based on the risk of seizures after ischaemic stroke 

Kai Michael Schubert  ¹ , Giulio Bicciato  ¹ , Lucia Sinka  ^{1   2} , Laura Abraira  ³ , Estevo Santamarina  ³ , José Álvarez-Sabín  ³ , Carolina Ferreira-Atuesta  ^{4   5} , Mira Katan  ^{1   6} , Natalie Scherrer  ¹ , Robert Terziev  ¹ , Nico Döhler  ^{7   8} , Barbara Erdélyi-Canavese  ⁷ , Ansgar Felbecker  ⁷ , Philip Siebel  ⁷ , Michael Winklehner  ⁹ , Tim J von Oertzen  ⁹ , Judith N Wagner  ^{9   10} , Gian Luigi Gigli  ¹¹ , Annacarmen Nilo  ¹¹ , Francesco Janes  ¹¹ , Giovanni Merlino  ¹¹ , Mariarosaria Valente  ¹¹ , María Paula Zafra-Sierra  ¹² , Luis Carlos Mayor-Romero  ¹² , Julian Conrad  ^{13   14} , S Evers  ^{13   15} , Piergiorgio Lochner  ¹⁶ , Frauke Roell  ¹⁶ , Francesco Brigo  ¹⁷ , Carla Bentes  ¹⁸ , Rita Peralta  ¹⁸ , Teresa Pinho E Melo  ¹⁸ , Mark R Keezer  ^{19   20} , John Sidney Duncan  ⁴ , Josemir W Sander  ^{4   19   21} , Barbara Tettenborn  ⁷ , Matthias Koepp  ⁴ , Marian Galovic  ^{22   4}

Affiliations

• PMID: 38749674
• DOI: 10.1136/jnnp-2024-333505

Free article

Abstract

Background: In addition to other stroke-related deficits, the risk of seizures may impact driving ability after stroke.

Methods: We analysed data from a multicentre international cohort, including 4452 adults with acute ischaemic stroke and no prior seizures. We calculated the Chance of Occurrence of Seizure in the next Year (COSY) according to the SeLECT_2.0 prognostic model. We considered COSY<20% safe for private and <2% for professional driving, aligning with commonly used cut-offs.

Results: Seizure risks in the next year were mainly influenced by the baseline risk-stratified according to the SeLECT_2.0 score and, to a lesser extent, by the poststroke seizure-free interval (SFI). Those without acute symptomatic seizures (SeLECT_2.0 0-6 points) had low COSY (0.7%-11%) immediately after stroke, not requiring an SFI. In stroke survivors with acute symptomatic seizures (SeLECT_2.0 3-13 points), COSY after a 3-month SFI ranged from 2% to 92%, showing substantial interindividual variability. Stroke survivors with acute symptomatic status epilepticus (SeLECT_2.0 7-13 points) had the highest risk (14%-92%).

Conclusions: Personalised prognostic models, such as SeLECT_2.0, may offer better guidance for poststroke driving decisions than generic SFIs. Our findings provide practical tools, including a smartphone-based or web-based application, to assess seizure risks and determine appropriate SFIs for safe driving.

Keywords: Activities of Daily Living; CLINICAL NEUROLOGY; EPILEPSY; STROKE.

© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.