Abstracts

Rationale: Driving is an important factor contributing to good quality of life in patients with epilepsy. Little work has been undertaken to explore the details of driving experience alone in this patient population. We wish to assess the driving status of our patients prior to and following surgery for epilepsy. We also seek to determine what associations exist between patient characteristics and post-operative driving status. Methods: The participants were selected from those adult patients with epilepsy who have required surgical treatment at our home institution between 2006 and 2010. Each participant received a questionnaire asking about driving and seizure status before and after surgery. The surveys were distributed using a modified Dillman approach. Pre- and peri-operative patient data was obtained from the electronic medical record system, in addition to a previously assembled epilepsy database from the Neurology Department at our institution. Data points were analyzed to look for significant associations with driving outcomes. Results: 140 eligible patients were included in the survey population; 78 patients returned a questionnaire for a response rate of 55.7%. 80% of patients experienced driving as a regular part of life at some point prior to surgery. At the time of the questionnaire distribution, 68% of patients had returned to regular driving. Demographic characteristics, including sex, race, average age at onset of seizures, average age the patient began driving, average age the patient obtained a first license, and average age at time of surgery did not play a significant role in whether or not the patient had a favorable driving outcome after surgery. However, patients who had a history of driving on a regular basis prior to surgery had significantly higher rates of good driving outcomes (p=0.001). Also, patients on whom intracranial electroencephalography (EEG) was utilized during surgery had worse driving outcomes (p=0.03). Conclusions: A surprisingly high percentage of epilepsy patients have experienced driving on a regular basis prior to surgery. While an exact number of patients not driving in the immediate few months before surgery is not available, we can assume that most were not driving given the fact that they had progressed to requiring surgery for treatment of their epilepsy. Thus, a driving rate of 68% after surgery can be considered good. While it is intuitive that a patient's pre-operative driving status would have an effect on post-operative driving, the role of intracranial EEG monitoring is less clear. Perhaps the use of intracranial EEG denotes a more complex case of epilepsy, and therefore a higher likelihood of poor driving outcomes. Either way, this data provides assistance in pre-operative counseling to patients. More investigation needs to be completed into other patient data points - such as seizure types, MRI findings, and patient motivators for driving - as possible predictors of driving outcomes.