Clinicians often decide on driving privileges based on SWD duration or other EEG features. On the other hand, some SWD are truly asymptomatic in which case driving privileges should not be restricted.
Specialized behavioral testing has demonstrated prolonged reaction times or missed responses during SWD, which may present a driving hazard even when patients or family members do not notice any deficits. A serious challenge arises when patients with no clinical seizures request driving privileges and licensure, yet their EEG shows generalized SWD. However, some generalized SWD have no obvious behavioral effects.
In clinically obvious cases, generalized SWD produce myoclonic, atonic/tonic or absence seizures with brief episodes of staring and behavioral unresponsiveness. Generalized spike-wave discharges (SWD) are the hallmark of generalized epilepsy on the electroencephalogram (EEG).
