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Review
. 2021 Dec 6;3(2):e000210.
doi: 10.1136/bmjno-2021-000210. eCollection 2021.

Driving restrictions following deep brain stimulation surgery

Andrew Roy Charmley  1 , Thomas Kimber  2   3 , Neil Mahant  4 , Alexander Lehn  1   5
Affiliations
Review

Driving restrictions following deep brain stimulation surgery

Andrew Roy Charmley et al. BMJ Neurol Open. .

Abstract

Background: There are currently no Australian guidelines to assist clinicians performing deep brain stimulation (DBS) procedures in setting postoperative driving restrictions.

Purpose: We aimed to provide recommendations for post-DBS driving restrictions to guide practice in Australia.

Methods: A review of current Australian and international driving guidelines, literature regarding the adverse effects of DBS and literature regarding the long-term effect of neurostimulation on driving was conducted using Elton B Stephens Company discovery service-linked databases. Australian neurologists and neurosurgeons who perform DBS were surveyed to gain insight into existing practice.

Results: No guidance on driving restrictions following DBS surgery was found, either in existing driving guidelines or in the literature. There was a wide difference seen in the rates of reported adverse effects from DBS surgery. The most serious adverse events (haemorrhage, seizure and neurological dysfunction) were uncommon. Longer term, there does not appear to be any adverse effect of DBS on driving ability. Survey of Australian practitioners revealed a universal acceptance of the need for and use of driving restrictions after DBS but significant heterogeneity in how return to driving is managed.

Conclusion: We propose a 6-week driving restriction for private licences and 6-month driving restriction for commercial licences in uncomplicated DBS. We also highlight some of the potential pitfalls and pearls to assist clinicians to modify these recommendations where needed. Ultimately, we hope this will stimulate further examination of this issue in research and by regulatory bodies to provide more robust direction for practitioners performing DBS implantation.

Keywords: Parkinson's disease; clinical neurology; dystonia; neurosurgery; tremor.

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Conflict of interest statement

Competing interests: ARC was participating in a movement disorders fellowship in 2019 partially funded by Abbott medical. TK had paid travel to DBS workshop (DBS user group meeting) paid for by Medtronic. NM reports no conflicts of interest. AL reports no conflicts of interest. This article was written by the authors with no input from any outside entity. The editing, recommendations and decision to published were not influenced by any external entity.

References

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