Assessing Medical Fitness to Drive in People Living with Post-Traumatic Seizure: A Survey Among Neurologists and Neurosurgeons in India

Abstract In India there are no clear-cut guidelines for giving medical fitness to resume driving following post-traumatic seizures (PTS). This leaves the medical professionals in jeopardy as such gray areas can have serious medico-legal implications. Against this background, we conducted a nationwide survey among neurologists and neurosurgeons to identify the norms and practices followed by them when issuing fitness certificates for this purpose. A questionnaire consisting of 12 questions and an open-ended question for suggestions if any, was developed and set up using SurveyMonkey App (Table 1). A total of 2,400 neurologists and neurosurgeons in India were contacted between May 03, 2025and August 01, 2025 through email and WattsApp. Of these, 508 responses were considered valid. Most of our responders (n = 385, 76%) agreed that, patients with PTS can resume driving after an adequate seizure-free interval (SFI). Regarding SFI most of the doctors (n = 199, 39%) agreed on a SFI of 1 year. Majority of doctors (n = 423, 83%) demanded that separate fitness criteria is required for PTS and other types of epilepsy. A total of 44 people (9%) pointed out that there are no definite criteria laid down for this purpose and most of them (n = 487, 96%) agreed that medico legal aspects of certification of drivers must be included in the curriculum of neurosurgery and neurology residency programs. Our survey throws light on the arbitrariness and inconsistencies of practices among doctors while giving fitness drive. The results of the survey underscore the importance of formulating clear and unambiguous guidelines for this purpose.