A patient with newly diagnosed epilepsy tells you she has not informed the DVLA and intends to keep driving her children to school. How do you proceed?

Question

A 36-year-old woman had a first witnessed generalised tonic-clonic seizure six weeks ago and a second last week. She lives rurally, her husband works away, and she says there is no other way to get her children to school.

Accepted Answer

My duty is to inform her clearly, to document that I have done so, and to escalate only if she continues to drive despite that. I would start by explaining the position precisely: the legal obligation to notify the DVLA is hers, not mine, and driving without doing so is an offence and invalidates her insurance. I would give her the specific seizure-free periods that apply to a Group 1 licence after more than one unprovoked seizure, and explain that they are longer for Group 2, and I would put that in writing and copy her GP as well as recording it in the notes. Then I would spend most of the consultation on why she is refusing, because she is not being reckless — she has two children, a husband who works away, and no public transport. I would ask what would actually make it possible: whether the school has transport, whether the local authority provides help for children whose parent has a medical condition, whether family or other parents could share the run, whether social services or a school welfare officer could assist. Those conversations resolve more of these cases than any restatement of the rule. I would also frame the risk in the terms that matter to her — that a seizure at the wheel would most likely happen with her children in the car — because that argument changes minds when the legal one does not. If, having done all that, she still intended to drive, then continuing to say nothing would expose others to a risk of death or serious harm, and disclosure to the DVLA medical adviser would be justified in the public interest. I would tell her first, document my reasoning, and discuss it with my consultant before acting.

Epilepsy, Driving and a Patient Who Will Not Stop

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