학술논문
Simulated driving in the epilepsy monitoring unit: Effects of seizure type, consciousness, and motor impairment.
Document Type
Article
Author
Kumar, Avisha; Martin, Reese; Chen, William; Bauerschmidt, Andrew; Youngblood, Mark W.; Cunningham, Courtney; Si, Yang; Ezeani, Cel; Kratochvil, Zachary; Bronen, Jared; Thomson, James; Riordan, Katherine; Yoo, Ji Yeoun; Shirka, Romina; Manganas, Louis; Krestel, Heinz; Hirsch, Lawrence J.; Blumenfeld, Hal
Source
Subject
*EPILEPSY
*SEIZURES (Medicine)
*CONSCIOUSNESS
*MYOCLONUS
*AUTOMOBILE driving simulators
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Language
ISSN
0013-9580
Abstract
People with epilepsy face serious driving restrictions, determined using retrospective studies. To relate seizure characteristics to driving impairment, we aimed to study driving behavior during seizures with a simulator. Patients in the Yale New Haven Hospital undergoing video‐electroencephalographic monitoring used a laptop‐based driving simulator during ictal events. Driving function was evaluated by video review and analyzed in relation to seizure type, impairment of consciousness/responsiveness, or motor impairment during seizures. Fifty‐one seizures in 30 patients were studied. In terms of seizure type, we found that focal to bilateral tonic–clonic or myoclonic seizures (5/5) and focal seizures with impaired consciousness/responsiveness (11/11) always led to driving impairment; focal seizures with spared consciousness/responsiveness (0/10) and generalized nonmotor (generalized spike–wave bursts; 1/19) usually did not lead to driving impairment. Regardless of seizure type, we found that seizures with impaired consciousness (15/15) or with motor involvement (13/13) always led to impaired driving, but those with spared consciousness (0/20) or spared motor function (5/38) usually did not. These results suggest that seizure types with impaired consciousness/responsiveness and abnormal motor function contribute to impaired driving. Expanding this work in a larger cohort could further determine how results with a driving simulator may translate into real world driving safety. [ABSTRACT FROM AUTHOR]