癫痫患者驾驶机动车时首次痫性发作五例分析  

Patients with epilepsy who had a first seizure while driving a motor vehicle:a report of five cases

作　　者：王岩 王品淳 马欣楠 陆叶婷 朱翔毅[1] 高薇[2] 徐敏[1] 李岩[3] 胡小伟[1] WANG Yan;WANG Pinchun;MA Xinnan;LU Yeting;ZHU Xiangyi;GAO Wei;XU Min;LI Yan;HU Xiaowei(Department of Neurology,the First Affiliated Hospital of Soochow University,Suzhou 215006,China;Department of Neurosurgery,the First Affiliated Hospital of Soochow University,Suzhou 215006,China;Department of Neurology,Children's Hospital of Soochow University,Suzhou 215006,China)

机构地区：[1]苏州大学附属第一医院神经内科,苏州215006 [2]苏州大学附属第一医院神经外科,苏州215006 [3]苏州大学附属儿童医院神经内科,苏州215006

出　　处：《癫痫杂志》2025年第1期35-40,共6页Journal of Epilepsy

基　　金：中国抗癫痫协会癫痫科研基金(CU-2022-023);江苏省老年健康科研项目(LKM2022019)。

摘　　要：目的初步分析癫痫患者驾驶机动车时出现首次痫性发作的现象,探讨其危害和可能的应对策略。方法2020年6月—2023年3月至苏州大学附属第一医院就诊的癫痫患者中,调查其在驾驶机动车时出现首次痫性发作的情况。结果共5例患者首次痫性发作于驾驶机动车过程中,均造成交通事故。1例患者首次痫性发作为全面强直-阵挛发作,2例为伴有意识障碍的局灶性发作进展为全面性发作,2例为局灶性发作伴知觉障碍。其中1例患者造成严重交通事故,包括导致1名电动车骑行者死亡,此案中患者被吊销驾照。其余4例患者首次痫性发作后继续开车,1例癫痫确诊5个月后终止驾驶,2例患者驾驶频率减少,1例患者驾驶频率无改变;其中2例患者在后续驾车时仍有癫痫发作,其中1例第二次痫性发作竟然也出现在驾驶中。结论驾驶中首次痫性发作可能并不少见,反映癫痫与驾驶问题的严峻性,由此导致的交通事故可以是致命的。癫痫患者驾驶目前在中国不被允许,患者首次痫性发作后,应停止驾驶机动车并就诊于癫痫专科,避免进一步危害自身和公共安全。Objective To preliminarily analyse the phenomenon of the first seizure in patients with epilepsy while driving a motor vehicle,and discuss its harms and possible coping strategies.Methods The first seizure while driving a motor vehicle was investigated among epilepsy patients who attended the First Affiliated Hospital of Soochow University from June 2020 to March 2023.Results A total of five patients had their first seizure while driving a motor vehicle,all causing traffic accidents.One patient had a generalized tonic-clonic seizure with a first epileptic seizure,two had focal seizures with impaired consciousness that progressed to generalized seizures,and two had focal seizures with impaired awareness.One of the patients caused a fatal traffic accident,leading to the death of another person who riding the electric bicycle.In this case,the patient's driving license was revoked.The other four patients continued to drive after the first seizure.One patient terminated driving 5 months after the diagnosis of epilepsy.Two patients drove less since then,and one patient continued driving as before.Two patients experienced seizures again while driving,and one of them coincidentally had his second seizure while driving.Conclusions The first seizure while driving may not be uncommon,reflecting the severity of epilepsy and driving,in which traffic accidents can be fatal.People with epilepsy are currently prohibited from driving in China.After the first seizure,patients should immediately stop driving and go to see an epileptologist,avoiding further endangering themselves and the public.

关 键 词：癫痫 驾驶 首次痫性发作 

分 类 号：R742.1[医药卫生—神经病学与精神病学]