Allegheny Health Network Neurologist Helps Modernize Pennsylvania’s Epilepsy Driving Regulations

PITTSBURGH - For people living with epilepsy, the inability to drive following a seizure often comes with frustration, a loss of freedom, and dependency on friends and family members for transportation. Complicating matters, different states have different post-seizure disqualification periods.

For years, in order for a person with epilepsy to resume driving in Pennsylvania, the minimum seizure-free period was six months - a waiting period that was out of step with national medical guidelines.

But as of March 28, the waiting period in Pennsylvania has been reduced to three months, thanks in part to Dr. Andrea Synowiec, System Vice Chair for the Department of Neurology at Allegheny Health Network (AHN) and a member of Pennsylvania Department of Transportation (PennDOT) Medical Advisory Board.

The updated regulation brings Pennsylvania into alignment with longstanding recommendations from the American Epilepsy Society, the American Academy of Neurology, and the Epilepsy Foundation of America, organizations that have advocated for the three-month standard since the 1990s.

"Our state laws weren't in line with current medical guidelines," said Dr. Synowiec. "This change was a long time coming."

Dr. Synowiec joined PennDOT's Medical Advisory Board about six years ago and began advocating for the change shortly after.

The board is a multidisciplinary group that includes physicians across various specialties as well as legal and public health experts. The group spent several years reviewing clinical data, public safety considerations, and patient impact before unanimously supporting the change.

The Independent Regulatory Review Commission approved the change on Jan. 15, leading to the new rule that took effect in March.

Epilepsy is a class of brain disorders characterized by chronic, recurrent seizures. It can have a variety of causes, including head injury, stroke, infectious disease, and genetic factors. Over 3.4 million Americans have been diagnosed with the disease. More than 169,000 to over 200,000 people in Pennsylvania are estimated to be living with epilepsy or another seizure disorder.

The science behind the revision is straightforward: Research has long shown that longer driving restrictions do not necessarily translate to greater public safety, in large part because patients frequently disregard restrictions they find impossible to follow.

"When you tell someone they can't drive for six months or longer, they're going to lose their job, so a lot of them drive anyway," said Dr. Synowiec. "Three months is the highest risk time, and a short enough window that people are more likely to obey the law."

The regulatory change reflects evolving medical understanding of epilepsy and seizure risk.

Historically, individuals with epilepsy were broadly prohibited from driving. Over time, advances in medication and treatment have significantly improved seizure control, prompting states to revisit restrictions that were once considered necessary.

Research reviewed by the Medical Advisory Board demonstrated that shorter restriction periods improve patient adherence without increasing crash risk. Studies from other states, including Arizona, found no rise in seizure-related crashes after reducing driving restrictions from 12 months to three months. Additionally, data show that longer restrictions often lead to noncompliance, with some patients continuing to drive without medical guidance due to the burden of prolonged limitations.

Pennsylvania's revised regulation maintains its requirement for physician reporting of seizure activity, ensuring that medical professionals continue to play a central role in determining when patients can safely return to driving.

"This is a meaningful step forward for patients across the Commonwealth," said Dr. Synowiec. "It reflects what medicine has known for years and what patients have needed for just as long. We're also giving physicians the ability to keep high-risk patients in a safe position while still maximizing freedom for everyone else."

For patients and families, the impact of the change is expected to be substantial. Shorter restriction periods can reduce financial strain, improve access to employment and care, and lessen the emotional burden associated with prolonged loss of independence.

It also means patients may be more likely to report seizures to their doctors, since the restrictions won't be as severe.

"People shouldn't be afraid to talk to their doctors about a seizure and get the care they need, and our streets will be safer because of it," Dr. Synowiec said. "I'm really proud of how it came together."