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Neurologic Conditions: Assessing Medical Fitness to Drive

Department of Internal Medicine, Marshfield Clinic, Marshfield, Wisconsin

Phiroze Hansotia, MD

Emeritus Physician, Department of Neurology, Marshfield Clinic, Marshfield, Wisconsin

Dawn Knapp, OTR

Department of Occupational Therapy, Saint Joseph’s Hospital, Marshfield, Wisconsin

John Ehrfurth, PhD

Department of Neuropsychology, Marshfield Clinic, Marshfield, Wisconsin

REPRINT REQUESTS: Steven Yale, MD, Department of Internal Medicine, Marshfield Clinic, 1000 North Oak Avenue, Marshfield, WI 54449, Telephone: 715-387-5436, Fax: 715-389-3808, Email: yale.steven{at}marshfieldclinic.org

Clinicians are often asked to make an assessment on whether a patient is medically fit to drive, even though few have been formally trained in this area. Driving is a complex task that requires having adequate operational, cognitive and higher executive functions that work together. These functions can be compromised to a greater or lesser extent in neurological disorders, such as stroke, traumatic brain injury, peripheral neuropathy, dementia, Parkinson’s disease and epilepsy. There is insufficient standardized information relating to impaired function at this time. Because of this, state laws vary in their assessment of medical conditions as they relate to driver licensing. Wisconsin laws are reviewed as an example. There are numerous assessment tests for various functions, but they lack a validated correlation with actual driving performance. These and other factors, as well as practical recommendations for the practicing physicians, are the subjects of this review.

Key Words: Driving restrictions • Seizures • Parkinson’s disease • Dementia

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