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A 32-year-old man is evaluated in the emergency department after a minor motor vehicle accident that occurred after he œblacked out. A police officer witnessed this event and described the patient as confused and disoriented at the scene of the accident. He was cooperative with paramedics and appeared to be acting appropriately by the time he reached the emergency department.

Physical examination is normal. Electrolyte and glucose levels are normal, and toxicology screen is negative. CT scan of the head is normal. He is told to make an appointment with his physician.

What is the most appropriate response to the patient's driving?

A Advise him to only drive locally
B Reassure the patient that driving is allowed
C Advise the patient to drive only with a passenger
D Ensure that the state Department of Motor Vehicles is notified

BB

D...

cibik ....Why is D?

This pt has a sudden loss of consciousness and most probably might be due to a seizure disorder...One needs to do a thorough examination including CNS and CVS but all state DMVs require that an episode of unconsciousness be reported to them.....Am i right?

yu are rt...

All states require that an episode of loss of awareness be reported to government authorities, either to the Department of Health or to the Department of Motor Vehicles.

This man has had a sudden event of loss of awareness, which is likely to have been a seizure. The consideration is whether this was a symptomatic seizure or, if unprovoked, whether he is at risk for recurrent unprovoked seizures and epilepsy.

A primary cardiac event should be excluded, and he should be scheduled for an electroencephalogram and an MRI of the head. Although state laws vary, all states require that an episode of loss of awareness be reported to government authorities, either to the Department of Health or to the Department of Motor Vehicles. In some states, the physician is required to notify the patient that it is his or her responsibility, whereas other states require that the physician file the report. Failure to follow applicable regulations places the physician at personal liability.
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D is rt ans