Frequency of severe traffic and transportation accidents is greater in individuals with epilepsy compared with generally healthy individuals, an association that appears to be independent of antiepileptic drug use, according to study findings published in Neurology.

Using Swedish registers, investigators evaluated traffic accidents in a total of 29,220 adults with epilepsy and compared these cases with 267,637 matched controls. A Cox regression analysis was used to examine the risk for severe traffic accidents in the two groups and a stratified Cox regression analysis was used to compare the groups for risk during medication and non-medication use periods.

Individuals with epilepsy had a significantly increased risk for serious transportation accidents compared with matched controls after adjusting for employment and civil status, education, living area, psychiatric disorders, and psychotropic medication use (hazard ratio [HR] 1.37; 95% CI, 1.29-1.46). Specifically, individuals with epilepsy had a higher risk for car accidents (HR 1.31; 95% CI, 1.19-1.44), pedestrian accidents (HR 2.24; 95% CI, 1.69-2.97), and bicycle accidents (HR 1.68; 95% CI, 1.49-1.89). Antiepileptic drug use was not associated with these risks, according to findings from population-level (HR 0.97; 95% CI, 0.85-1.11) and within-individual (HR 0.99; 95% CI, 0.69-1.42) comparisons.

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The registers used in this study did not collect information on whether individuals with epilepsy were actually responsible for the transportation accidents, which may have limited the findings. In addition, the findings may be limited to the Swedish population and may not generalize to other patient populations.

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Greater study and knowledge regarding serious transportation accidents in individuals with epilepsy may make it “possible to educate individuals with epilepsy about preventive measures rather than implement stricter regulations.”


Sundelin HEK, Chang Z, Larsson H, et al. Epilepsy, antiepileptic drugs, and serious transport accidents: A nationwide cohort study [published online February 28, 2018]. Neurology. doi:10.1212/WNL.0000000000005210