Intended for healthcare professionals


The dangers of long distance running and other stories . . .

BMJ 2014; 348 doi: (Published 28 May 2014) Cite this as: BMJ 2014;348:g3459

After a first epileptic fit, most countries in the world impose a driving ban of several months. The overall risk of a further seizure is about 50%, but the risk declines steeply with time. The Western Australian first seizure database, established in 2000, allows an accurate stratified assessment of risk after unprovoked fits or fits provoked by brain lesions or systemic factors (Neurology, Neurosurgery and Psychiatry 2014, doi:10.1136/jnnp-2013-307529). On the basis of an accident risk ratio of 2.5%, it seems that driving should be banned for at least eight months after an unprovoked seizure, and at least five months after a provoked seizure, which is longer than most jurisdictions currently impose.

In determining cases of suicide, coroners in the UK have to establish “beyond reasonable doubt” that the person intended to kill himself or herself. This is a legacy of the days before 1961, when suicide was a criminal act …

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