German Center for Vertigo and Balance Disorders, University Hospital, Ludwig-Maximilians University, Marchioninistr. 15, 81377, Munich, Germany.
Department of Neurology, University Hospital Zurich, University of Zurich, Frauenklinikstrasse 26, 8091, Zurich, Switzerland.
J Neurol. 2018 Oct;265(Suppl 1):9-17. doi: 10.1007/s00415-018-8806-y. Epub 2018 Mar 13.
A common European Community driving licence was established in 1980. However, there are major differences among the countries as regards medical conditions that legally affect driving ability. This article discusses various assessment guidelines for dizzy patients. These range from a total absence of specified binding requirements in Finland or regulations open to clinical interpretation in Switzerland, to inappropriately strict regulations in Germany. We focus on requirements for patients with vestibular disorders in Germany which have been in force since 2014. These guidelines stipulate that for group 1 driving licence (private cars < 3.5 t, motorbikes): (1) patients with Menière's disease (attacks without prodromes) must have had no attacks for 2 years before it is possible to drive again. (2) Patients with vestibular migraine without prodromes must not have had any attacks for 3 years. For a group 1 and group 2 driving licence ("professional driver"): (3) patients with bilateral vestibulopathy as a rule are considered to have a driving disability. Similarly, strict restrictions have been formulated for ocular motor disorders such as downbeat and upbeat nystagmus and for patients with functional (psychosomatic) forms of dizziness such as phobic postural vertigo. The authors represent a working group of the European Dizzynet focusing on the topic "fitness to drive with vertigo and balance disorders". They agree that European guidelines must be revised and harmonized, for some are too strict and the required dizziness-free intervals are too long; others must be revised, for they are too lax. A common European standard is needed.
1980 年设立了一份普通的欧洲共同体驾驶执照。然而，各国之间在法律上影响驾驶能力的医疗条件方面存在重大差异。本文讨论了各种针对头晕患者的评估指南。这些指南从芬兰完全没有具体的规定要求或瑞士的规定可由临床解释，到德国的规定过于严格。我们专注于德国自 2014 年以来针对前庭障碍患者的要求。这些指南规定，对于第 1 组驾驶执照（私家车<3.5 吨，摩托车）：（1）患有梅尼埃病（无先兆发作）的患者必须在再次驾驶之前没有发作 2 年。（2）无先兆发作的前庭性偏头痛患者必须在 3 年内没有发作。对于第 1 组和第 2 组驾驶执照（“职业司机”）：（3）双侧前庭病患者通常被认为有驾驶残疾。同样，对眼球运动障碍（如下垂性和上扬性眼球震颤）和功能性（心身性）头晕患者（如恐惧症姿势性眩晕）也制定了严格的限制。作者代表欧洲 Dizzynet 专注于“头晕和平衡障碍驾驶能力”的工作组。他们同意必须修订和协调欧洲指南，因为有些过于严格，需要无头晕间隔过长；其他的必须修订，因为它们过于宽松。需要一个共同的欧洲标准。
