PURPOSE: Epilepsy patients consider driving issues to be one of their most serious concerns. Ideally, decisions regarding fitness to drive should be based upon thorough evaluations by specialists in epilepsy care. In 2009, an EU directive was published aiming to harmonize evaluation practices within European countries, but, despite these recommendations, whether all epileptologists use the same criteria is unclear. We therefore conducted this study to investigate routine practices on how epileptologists at European epilepsy centers evaluate fitness to drive. METHODS: A questionnaire was sent to 63 contact persons identified through the European Epi-Care and the E-pilepsy network. The questionnaire addressed how fitness-to-drive evaluations were conducted, the involvement of different professionals, the use and interpretation of EEG, and opinions on existing regulations and guidelines. RESULTS: The questionnaire was completed by 35 participants (56 % response rate). Results showed considerable variation regarding test routines and the emphasis placed on the occurrence and extent of epileptiform discharges revealed by EEG. 82 % of the responders agreed that there was a need for more research on how to better evaluate fitness-to-drive in people with epilepsy, and 89 % agreed that regulations on fitness to drive evaluations should be internationally coordinated. CONCLUSION: Our survey showed considerable variations among European epileptologists regarding use of EEG and how findings of EEG pathology should be assessed in fitness-to-drive evaluations. There is a clear need for more research on this issue and international guidelines on how such evaluations should be carried out would be of value.

Department for Clinical Neurosciences HUG University Hospitals and Faculty of Medicine Geneva Switzerland

Department of Clinical Neuroscience Institute of Neuroscience and Physiology Sahlgrenska Academy University of Gothenburg and Department of Neurology Sahlgrenska University Hospital Gothenburg Sweden

Department of Epileptology University Hospital Bonn Germany

Department of Functional Neurology and Epileptology Hospices Civils de Lyon and University of Lyon Lyon's Neurosciences Research Center Lyon France

Department of Neurology Charles University 2nd Faculty of Medicine Motol University Hospital Prague Czech Republic

Department of Neurology Epilepsy Program Hospital Ruber Internacional Madrid Spain

Department of Neurology Institute of Clinical Medicine Faculty of Medicine Vilnius University Vilnius Lithuania

Department of Neurology University Hospital Basel Switzerland

Department of Pediatric Neuroloy Al Obregia' Clinical Hospital Carol Davila University of Medicine and Pharmacy Bucharest Romania

Division of Clinical Neuroscience National Centre for Epilepsy Oslo University Hospital Norway

EEG and Epilepsy Unit Department of Neurology University Hospitals and Medical School of Geneva Geneva Switzerland

Epilepsiezentrum Frankfurt Rhein Main Zentrums der Neurologie und Neurochirurgie Universitätsklinikum Frankfurt Goethe Universität Frankfurt am Main Germany

Epilepsiezentrum Kork Kork Germany

Epilepsy Center Frankfurt Rhine Main University Hospital Frankfurt and Center for Personalized Translational Epilepsy Research Goethe University Frankfurt Germany; Department of Neurology Yale University School of Medicine New Haven USA

Epilepsy Center Medical Center University of Freiburg Freiburg Germany

Epilepsy Centrum Department of Neurology National Institute of Clinical Neurosciences Budapest Hungary

Helsinki University Hospital Neurocenter Epilepsia Helsinki Finland

IRCCS Institute of Neurological Sciences of Bologna Bologna Italy

Juhász Pál Epilepsy Centrum National Institute of Clinical Neuroscience Budapest Hungary

Laboratory of Clinical Neurophysiology AHEPA University Hospital Aristotle University of Thessaloniki Thessaloniki Greece

Neuro Center University North Zagreb Croatia

Neurocentre Bellevue Zurich Switzerland

Neurology Department University Hospital Strasbourg France

RehaClinic Kilchberg ZH Kilchberg Switzerland

UCL Queen Square Institute of Neurology London UK

University Emergency Hospital of Bucharest Epilepsy Monitoring Unit Neurology Department Bucharest Romania

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