Alexander M. Crizzle, Sherrilene Classen, Christina LaFranca, Sandra M. Winter, Steven N. Roper, Stephan Eisenschenk; Assessing the Driving Performance of a Person With Epilepsy Presurgery and Postsurgery. Am J Occup Ther 2013;67(3):e24–e29. https://doi.org/10.5014/ajot.2013.006569
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© 2020 American Occupational Therapy Association
Occupational therapists and certified driving rehabilitation specialists are uniquely skilled to assess functional abilities underlying driving performance. However, little information exists on the utility of clinical assessments to determine driving performance in people with epilepsy. This case study demonstrates how an occupational therapy evaluation battery was used to examine differences in visual and cognitive abilities and simulated driving performance before and after epilepsy surgery. Specifically, a 43-yr-old White man with right anterior lobe epilepsy underwent temporal lobectomy and had his driving-related abilities and simulated driving performance assessed pre- and postsurgery. The occupational therapy evaluation indicated improvements in executive skills, attention, and information processing speed postsurgery. Visuospatial abilities worsened after surgery, likely contributing to the modest increase in vehicle position errors on the driving simulator. Nevertheless, simulated driving performance improved after temporal lobectomy. Reductions in the number of visual scanning, lane maintenance, and speed regulation errors were recorded.
The Mini-Mental State Examination (MMSE; Folstein, Folstein, & McHugh, 1975), composed of 11 questions that cover domains of orientation, registration, attention, calculation, recall, language, and visuospatial perception requiring approximately 10 min to complete
The Trail Making Test Part B (Trails B), administered in a few minutes, which is a measure of executive function and visual–conceptual and visual–motor tracking (Reitan, 1958)
The Letter H Cancellation test (Uttl & Pilkenton-Taylor, 2001), a test of visual scanning and visual search that can be completed in ≤1 min.
In a single case, temporal lobectomy improved lane maintenance and speed regulation but affected vehicle positioning negatively.
Clinical tests of cognition and visuospatial abilities can be used to determine changes in those abilities to better understand the mechanisms for change in simulated driving performance pre- and postsurgery.
An occupational therapist may make a substantive contribution in assessing fitness to drive in PWE pre– and post–temporal lobectomy surgery.
Use of the CDS-250 driving simulator is a safe and efficient method to detect changes in the driving errors of PWE before and after temporal lobectomy surgery.
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