How should I assess a patient with a history of seizures regarding their ability to drive safely?

When assessing a patient with a history of seizures regarding their ability to drive safely, you should first take a detailed history of their seizures, including frequency, type, and any recent recurrences, as well as any modifiable risk factors such as mental health problems, vascular risk factors, or substance misuse that may increase seizure risk. Refer the patient urgently for specialist assessment if they have had a recent seizure or recurrence after remission. Use a person-centred approach to discuss individualised risks of further seizures and how these may impact driving safety. Advise the patient to check the Driver and Vehicle Licensing Agency (DVLA) regulations regarding driving with medical conditions and to notify the DVLA if required. Consider the impact of antiseizure medication adherence and side effects on cognition and alertness, which can affect driving ability. Provide information and support about seizure recognition, first aid, and safety measures to reduce the risk of further seizures while driving. If there is diagnostic uncertainty, consider specialist investigations such as EEG and neuroimaging to clarify seizure type and risk. Always ensure that the patient is informed about the legal and safety implications of driving with epilepsy or seizures and encourage shared decision-making regarding driving restrictions and risk management.