Implications_for

Neurocardiogenic Syncope and Driving.

Patients in the UK have a legal duty to inform the DVLA about any condition likely to affect their ability to drive safely. The address to write to is:

Driver and Vehicle Licensing Agency, Longview Road, Morriston, Swansea. SA99 1TU.

Where the individual concerned is uncertain about the need to contact the DVLA, he/she should seek advice from their GP or relevant specialist or contact the DVLA directly ( Car licence - Group 1 Entitlement - 0870 600 0301; lorry/bus driver - Group 2 Entitlement - 0870 241 1879) for advice. Failure to notify their insurance company may also affect the validity of his/her insurance.

When a patient contacts the DVLA, he/she may be informed that they may continue to drive (Section 88 of the Road Traffic Act) whilst investigations are being undertaken provided they have not been advised to cease doing so by their GP and/or specialist (and have actively sought that opinion) and hold a valid driving licence.

The doctor’s duty is to advise his/her patient when they should cease to drive and notify the DVLA. Where the doctor is uncertain he/she should consult "At a Glance Guide to the Current Medical Standards of Fitness to Drive", whether in its hard copy format or on the DVLA website for the latest guidelines.

Doctors may consult with the DVLA Medical Advisors on an anonymous case basis OR on a named basis with the individual's permission OR when there is evidence that an individual continues to drive despite being advised that he/she is unfit to do so. The GMC has produced specific guidelines on this aspect.

The DVLA classifies neurocardiogenic syncope into simple faints and "loss of consciousness, likely to be unexplained syncope". "Unexplained" means that no relevant cardiac or neurological abnormality has been found during examination. "Unexplained syncope" is sub classified into low and high risk groups.

	Group 1 Entitlement	Group 2 Entitlement
Simple faint - definite provocation factors with associated prodromal symptoms and unlikely to occur whilst sitting or lying	No driving restrictions	No driving restrictions
Unexplained syncope and low risk of re-occurrence	Can drive 4 weeks after the event	Can drive 3 months after the event
Unexplained syncope and high risk of re-occurrence	Can drive 4 weeks after the event if the cause has been identified and treated If no cause identified, then 6 months off	Can drive after 3 months if the cause has been identified and treated. If no cause, then licence refused/revoked for one year

Factors indicating high risk of re-occurrence:

Abnormal ECG

Clinical evidence of structural heart disease

Syncope causing injury, occurring at the wheel or whilst sitting or lying

More than one episode in previous six months

	Group 1 Entitlement	Group 2 Entitlement
Carotid Sinus Syndrome treated by pacemaker implantation when diagnosis secure	Driving must cease for at least 1 week	Disqualifies from driving for 6 weeks

The DVLA does require notification if the event is anything other than a simple faint. Failure to do so is a criminal offence punishable by a fine of up to £1,000.

Neurocardiogenic Syncope and Driving.

Group 1 Entitlement

Group 2 Entitlement

The DVLA does require notification if the event is anything other than a simple faint. Failure to do so is a criminal offence punishable by a fine of up to £1,000.

Last updated 19/01/2008