PMID- 30135255
OWN - NLM
STAT- MEDLINE
DCOM- 20190830
LR  - 20190830
IS  - 1526-632X (Electronic)
IS  - 0028-3878 (Linking)
VI  - 91
IP  - 12
DP  - 2018 Sep 18
TI  - Characteristics of motor vehicle crashes associated with seizure: Car crash 
      semiology.
PG  - e1102-e1111
LID - 10.1212/WNL.0000000000006208 [doi]
AB  - OBJECTIVE: To examine the characteristics of seizure-related vehicle crashes 
      (SRC). METHOD: Using a nested case-control design, we identified and compared 
      cases of SRC involving confirmed epilepsy patients with 137,126 
      non-seizure-related crash controls (NSRC) in the Australian state of Victoria. 
      SRC were identified from approximately 20,000 epileptologist medical records by 
      cross-referencing this source with the Victorian Police Traffic Incident database 
      and the Road Crash Information System Database (RCISD). RESULTS: Seventy-one SRC 
      involving 62 patients with epilepsy were identified. Thirty-seven SRC resulted in 
      injury and could be identified in the RCISD and compared to NSRC. Seizure-related 
      crashes typically involved a single vehicle (57% vs 29%, p < 0.001) carrying a 
      sole occupant (95% vs 48%, p = 0.001). Most SRC began with an "out of control 
      movement" (51% vs 10%, p < 0.001) and the subsequent collision type differed 
      significantly between the groups (p < 0.001). The majority of SRC were a 
      "collision with a fixed object" (54% vs 17%, p < 0.001) involving an "off path on 
      straight" mechanism (48% vs 10%, p < 0.001). Regarding all 71 SRC, generalized as 
      compared with focal epilepsy crashes involved younger drivers (p < 0.001), 
      seizure-provoking factors (p = 0.033), and occurred earlier in the day (p = 
      0.004). CONCLUSIONS: Given the distinct SRC features, we propose that clinicians, 
      crash investigators, and driver licensing authorities incorporate collision 
      characteristics into the overall assessment of suspected SRC. Further research 
      should examine restricting driving immediately after risk periods as a 
      harm-minimization strategy.
CI  - (c) 2018 American Academy of Neurology.
FAU - Neal, Andrew
AU  - Neal A
AD  - From the Departments of Neurology (A.N., R.C., W.J.D., M.J.C.) and Medicine 
      (W.J.D., M.J.C.), St Vincent's Hospital Melbourne; Department of Medicine, Royal 
      Melbourne Hospital (A.N.), and Graeme Clark Institute (M.J.C.), University of 
      Melbourne; Faculty of Health (R.C.), Deakin University; Victorian Institute of 
      Forensic Medicine, Department of Forensic Medicine (M.O.), Monash University; and 
      Corporate Strategy and Operational Improvement Department (D.B.), Victoria 
      Police, Melbourne, Australia. andrew.neal@unimelb.edu.au.
FAU - Carne, Ross
AU  - Carne R
AD  - From the Departments of Neurology (A.N., R.C., W.J.D., M.J.C.) and Medicine 
      (W.J.D., M.J.C.), St Vincent's Hospital Melbourne; Department of Medicine, Royal 
      Melbourne Hospital (A.N.), and Graeme Clark Institute (M.J.C.), University of 
      Melbourne; Faculty of Health (R.C.), Deakin University; Victorian Institute of 
      Forensic Medicine, Department of Forensic Medicine (M.O.), Monash University; and 
      Corporate Strategy and Operational Improvement Department (D.B.), Victoria 
      Police, Melbourne, Australia.
FAU - Odell, Morris
AU  - Odell M
AD  - From the Departments of Neurology (A.N., R.C., W.J.D., M.J.C.) and Medicine 
      (W.J.D., M.J.C.), St Vincent's Hospital Melbourne; Department of Medicine, Royal 
      Melbourne Hospital (A.N.), and Graeme Clark Institute (M.J.C.), University of 
      Melbourne; Faculty of Health (R.C.), Deakin University; Victorian Institute of 
      Forensic Medicine, Department of Forensic Medicine (M.O.), Monash University; and 
      Corporate Strategy and Operational Improvement Department (D.B.), Victoria 
      Police, Melbourne, Australia.
FAU - Ballek, David
AU  - Ballek D
AD  - From the Departments of Neurology (A.N., R.C., W.J.D., M.J.C.) and Medicine 
      (W.J.D., M.J.C.), St Vincent's Hospital Melbourne; Department of Medicine, Royal 
      Melbourne Hospital (A.N.), and Graeme Clark Institute (M.J.C.), University of 
      Melbourne; Faculty of Health (R.C.), Deakin University; Victorian Institute of 
      Forensic Medicine, Department of Forensic Medicine (M.O.), Monash University; and 
      Corporate Strategy and Operational Improvement Department (D.B.), Victoria 
      Police, Melbourne, Australia.
FAU - D'Souza, Wendyl J
AU  - D'Souza WJ
AD  - From the Departments of Neurology (A.N., R.C., W.J.D., M.J.C.) and Medicine 
      (W.J.D., M.J.C.), St Vincent's Hospital Melbourne; Department of Medicine, Royal 
      Melbourne Hospital (A.N.), and Graeme Clark Institute (M.J.C.), University of 
      Melbourne; Faculty of Health (R.C.), Deakin University; Victorian Institute of 
      Forensic Medicine, Department of Forensic Medicine (M.O.), Monash University; and 
      Corporate Strategy and Operational Improvement Department (D.B.), Victoria 
      Police, Melbourne, Australia.
FAU - Cook, Mark J
AU  - Cook MJ
AD  - From the Departments of Neurology (A.N., R.C., W.J.D., M.J.C.) and Medicine 
      (W.J.D., M.J.C.), St Vincent's Hospital Melbourne; Department of Medicine, Royal 
      Melbourne Hospital (A.N.), and Graeme Clark Institute (M.J.C.), University of 
      Melbourne; Faculty of Health (R.C.), Deakin University; Victorian Institute of 
      Forensic Medicine, Department of Forensic Medicine (M.O.), Monash University; and 
      Corporate Strategy and Operational Improvement Department (D.B.), Victoria 
      Police, Melbourne, Australia.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20180822
PL  - United States
TA  - Neurology
JT  - Neurology
JID - 0401060
SB  - IM
CIN - Neurology. 2018 Sep 18;91(12):543-544. PMID: 30135259
MH  - Accidents, Traffic/*statistics & numerical data
MH  - Adult
MH  - Age Factors
MH  - Case-Control Studies
MH  - Databases, Factual
MH  - Female
MH  - Humans
MH  - Male
MH  - Seizures/diagnosis/*epidemiology
MH  - Time Factors
MH  - Victoria/epidemiology
MH  - Young Adult
EDAT- 2018/08/24 06:00
MHDA- 2019/08/31 06:00
CRDT- 2018/08/24 06:00
PHST- 2018/01/29 00:00 [received]
PHST- 2018/06/11 00:00 [accepted]
PHST- 2018/08/24 06:00 [pubmed]
PHST- 2019/08/31 06:00 [medline]
PHST- 2018/08/24 06:00 [entrez]
AID - WNL.0000000000006208 [pii]
AID - 10.1212/WNL.0000000000006208 [doi]
PST - ppublish
SO  - Neurology. 2018 Sep 18;91(12):e1102-e1111. doi: 10.1212/WNL.0000000000006208. 
      Epub 2018 Aug 22.