Department of Psychiatry, University of Melbourne, Austin Health, Heidelberg Heights, VIC, Australia.
Department of Psychological Medicine, The Children's Hospital at Westmead, Westmead, NSW, Australia.
Aust N Z J Psychiatry. 2022 Feb;56(2):117-119. doi: 10.1177/00048674211009621. Epub 2021 Apr 22.
Patients with epilepsy have their authorisation to drive restricted under detailed guidelines, but the rules for those with non-epileptic seizures are far less clear. We surveyed specialist clinicians in Australia and found little agreement as to whether such guidelines existed for non-epileptic seizures or what they might be. A number of possible interpretations of the Australian fitness to drive guidelines are explored, and these are often vague in themselves, as well as uncertain in their scope. This means clinicians making momentous driving decisions for their patients with non-epileptic seizures are doubly challenged, first in interpreting what guidelines exist, and second in what they mean. The International League Against Epilepsy proposed specific guidelines for driving with non-epileptic seizures, which reflect the range of presentations of non-epileptic seizures in a decision-making algorithm. We believe a specific algorithm such as this is essential in removing one level of uncertainty and responsibility for clinicians, and restoring equity for patients with non-epileptic seizures.
癫痫患者的驾驶授权受到详细规定的限制，但对于非癫痫性发作患者的规定则远不明确。我们调查了澳大利亚的专科临床医生，发现对于非癫痫性发作是否存在此类指南，以及可能是什么指南，几乎没有达成一致意见。我们探讨了对澳大利亚驾驶适宜性指南的一些可能解释，这些解释本身往往很模糊，范围也不确定。这意味着为非癫痫性发作患者做出重大驾驶决策的临床医生面临双重挑战，首先是解释现有的指南，其次是理解这些指南的含义。国际抗癫痫联盟为非癫痫性发作驾驶制定了具体的指南，这些指南反映了非癫痫性发作的各种表现，形成了一个决策算法。我们认为，对于临床医生来说，这样一个具体的算法对于消除不确定性和责任至关重要，并为非癫痫性发作患者恢复公平性。
