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Feature article: Self driving vehicles: a solution for persons with epilepsy and poorly controlled seizures?

Epilepsy and seizures can impact many aspects of a person's life. One of the most troubling challenges that teens and adults with epilepsy and seizures often face involve driving privileges.  Losing driving privileges can create a slew of real-life complications (e.g., problems getting to work, performing everyday errands, etc.). Some people come up with innovative solutions to tackle this problem, such as getting rides from friends and relatives, obtaining funds from certain foundations to pay for cabs or driver apps (e.g., Lyft, Uber, etc.), figuring out public transportation options, going by foot to nearby locations, and so forth, but honestly, not being able to drive can be tough and sometimes make life chaotic.  So, when we started hearing about self-driving cars, our ears pricked up and we started to pay closer attention.  Some of the news stories we read reminded us of the 1960's cartoons "The Jetsons." Remember the self-driving/ flying car that the Jetson family used?  It seemed far-fetched back then but does not seem so outlandish anymore! Note, technology is still not quite where it needs to be for fully automated, self-driving cars that require zero input from the driver/passenger, but it's moving in the right direction (experts estimate it may take many years).  

But before we move on to self-driving cars, let's talk a little about driving and epilepsy (with seizures that are not well controlled).

When a person with uncontrolled epilepsy drives a motor vehicle, there is a risk for accidents, which could end up damaging property and worse yet, injuring or killing the driver and others.  There are different opinions about this issue but, bottom line, the reason that the Department of Motor Vehicles has the rules it does regarding driving and seizures is to ensure the public's safety.  

The length of driving restrictions and whether the doctor must report the patient to the local motor vehicles agency (or it is up to the patient's own responsibility), varies from state to state.  

For the most part, driving restrictions are based on expert opinion rather than on actual scientific evidence which may partly explain why different states have different regulations. (Krumholz, 2009).  Although all states allow people with epilepsy to drive, the specifics vary from one place to another as some states require one-year seizure-freedom while some require 6 months or 3 months seizure-freedom before allowed to drive again. To check your state's regulations you can either contact your local state's Motor Vehicles Department (MVD) or search for the Epilepsy Foundation's database of state regulations on its website (https://www.webmd.com/epilepsy/guide/seizures-driving).

And now, let's talk about self-driving vehicles and how they might be a solution to those living with epilepsy and seizures.  The electric car, solar panel and clean energy company, Tesla, has been at the forefront of research into self-driving vehicles.  Tesla has been working on developing driverless cars; these are vehicles that monitor the environment and drive with little to no human input by using electronic sensors.  There are several possible levels of automation going all the way from zero (which is pretty much any traditional car that is on the road right now) to Level 5. But even cars on the zero level, are increasingly featuring technological advances such as brake and blind-spot warnings and backup cameras.

Level 1 cars, include driver assistance features that are partially self-controlling (e.g., adaptive cruise control that can temporarily take over some braking and acceleration actions) but still require input from the driver most of the time.

Level 2 cars, have partial automation which means that they have some basic monitoring of the environment with certain advanced autonomous functions. Think: parallel parking assistance and lane departure warning and correction which requires the vehicle to perform some longitudinal and lateral control.

Level 3 cars have what is called "Conditional Automation" that means the driver can actually totally detach him/herself from driving the car for a big chunk of the time the car is traveling. However, the driver may need to re-engage and manually stop the car in case of a system failure or emergency. This system is not yet fully independent of all kinds of conditions that might be thrown its way (e.g., road types, weather conditions, and speed). But at this level, a car equipped with this type of automation could decide to overtake a vehicle in front of it and other such "driver decisions."

A level 4 car would be considered a "High Automation" car which would be, in nearly all respects, a truly driverless car. This system would be fully independent of all kinds of conditions that might be thrown its way (e.g., road types, weather conditions, and speed).  However, in extreme conditions (e.g., very bad weather) it might still need to alert the driver to step in and take over. 

By all estimates, level 5 cars are still a dream, but they are certainly being thought about and are on an early drawing board. These would be "Fully Automated" cars. They would be completely driverless, needing absolutely zero human involvement whatsoever. A voice command would be all that would be needed to get the car moving towards the desired destination.  The driver could relax completely watching a movie, talking on the phone or even sleeping while the car drives itself. These cars would be able to perceive the surroundings even in extreme weather conditions and could even drive in completely off-the-grid areas. However, as per CEO Elon Musk, Tesla FSD (full self-driving) and fully autonomous Level 5 vehicles are still some years away.  Some experts predict that these cars may not really be available for several decades.  Most importantly, we must be sure that the car is extremely safe so that accidents such as the one that occurred in 2019 does not repeat itself (https://www.npr.org/2022/01/18/1073857310/tesla-autopilot-crash-charges#:~:text=Press-,Tesla%20driver%20is%20charged%20in%20a%20deadly%20crash%20involving%20Autopilot,killed%20two%20people%20in%202019.). 

Once these Level 5 cars have been fully tested and cleared for use, they will be a tremendous asset for persons living with epilepsy and seizures. Imagine, they will not even have steering wheels or pedals! If the driver experiences a n alteration or loss of consciousness or movement as might occur with a seizure, the car will still be able to reach its destination safely. 

In sum, the epilepsy and seizure community needs to stay aware of and be vocal about the utility of these technological advances, so the companies that are developing them understand the importance of this market.  This novel technology can have a major impact from a human (improving lives) and financial viewpoint (the company's profits). We plan on checking in on the topic of driverless cars in a year or two and ask that if you become aware of important advances, you let the newsletter staff know (epilepsyny@epilepsygroup.com).

More reading materials on driverless-cars:

https://www.synopsys.com/automotive/autonomous-driving-levels.html#:~:text=Level%205%20cars%20won't,available%20to%20the%20general%20public.

https://www.hotcars.com/level-5-autonony-driverless-cars-when/

https://www.teslarati.com/tesla-self-driving-epilepsy-rights-progress-waymo/ 

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