Survey of physician attitudes towards psychogenic nonepileptic seizures and driving

Physicians from various disciplines encounter patients presenting with psychogenic nonepileptic seizures (PNES) as part of their routine clinical practice. Recommendations towards assessing fitness to drive and reporting are clearer for conditions such as neurocognitive disorders and epilepsy, but such guidelines do not exist for patients with PNES. Here, we assess physicians' attitudes towards driving for patients diagnosed with PNES. Electronic questionnaires were sent to Neurology and Family Medicine physicians practicing at Creighton University Medical Center and Psychiatry physicians practicing at Creighton-Nebraska Psychiatry Residency Program to assess their opinion regarding driving risk when encountering PNES. The survey request was sent to 125 physicians, of which close to 60% completed the survey. Eighty-eight percent of participants encountered PNES in their clinical practice, and 69.1% agreed it was a difficult problem to assess, with only 8.3% endorsing a belief that these patients should drive without restrictions. Ninety-three percent felt having guidelines would help them assess the driving risk in this population. Psychogenic nonepileptic seizures are common across neurology, psychiatry, and primary care, and most physicians find assessing driving risk in such individuals highly warranted yet difficult. Developing such assessment guidelines and recommendations is of great need for clinicians. •Recommendations towards assessing fitness to drive are clearer for epilepsy but such guidelines do not exist for patients with psychogenic non-epileptic seizures (PNEs).•A total of 125 physicians received an invitation to participate in the study. Of these, 64 were Psychiatrists, 11 were Neurologists, and 50 were Family Medicine.•88% of participants encountered PNEs in their clinical practice and 69.1% reported it was a difficult problem to assess, with only 8.3% endorsing a belief that these patients should drive without restrictions.•Most physicians 69.4% felt assessing driving risk to be a problem in this population and only 18% of physicians feeling confident with their assessment.•Approximately 61.1% reported having limited knowledge on how to assess and make driving decisions in this population with 55.6% reported having a limited experience in making this decision.•In our survey, 93.1% of respondents endorsed that guidelines on assessing driving ability of patients with PNEs would be very helpful.