Characteristics of Patients Diagnosed with Psychogenic Non-Epileptic Seizures (PNES) Who Request Reinstatement of Their Driving Privileges

Objective: To compare patients with psychogenic non-epileptic seizures (PNES) who requested reinstatement of driving privileges or reported having resumed driving to those who did not. Methods: Diagnosis of PNES was confirmed with videoEEG. Demographic and clinical data and requests for reinstatement of driving privileges (requiring 6 or more months seizure freedom) and reports of decisions to resume driving were noted. Self-report questionnaires of depression, anxiety and PTSD that were administered as part of neuropsychological assessment were analyzed. Results: Of 73 patients with PNES evaluated in 2018-2021, 22 later applied for driving privileges or reported that they resumed driving. When the two groups were compared, the group that applied for driving privileges or decided to resume driving was determined to be significantly less depressed (p = 0.014) when initially assessed than the group that did not. Conclusion: Resumption of driving behavior is an explicit measure of improvement for PNES because patients are advised to discontinue driving until they are seizure-free for a determined time span. Findings revealed that initial lower experienced levels of depression symptoms were associated with subsequent reported seizure-freedom which allowed for the reactivation of driving privileges. This underscores the importance that depression may have on PNES prognosis and supports assessing and treating comorbid mood symptoms in a timely manner.