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Dizziness in Europe: from licensed fitness to drive to licence without fitness to drive

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Abstract

A common European Community driving licence was established in 1980. However, there are major differences among the countries as regards medical conditions that legally affect driving ability. This article discusses various assessment guidelines for dizzy patients. These range from a total absence of specified binding requirements in Finland or regulations open to clinical interpretation in Switzerland, to inappropriately strict regulations in Germany. We focus on requirements for patients with vestibular disorders in Germany which have been in force since 2014. These guidelines stipulate that for group 1 driving licence (private cars < 3.5 t, motorbikes): (1) patients with Menière’s disease (attacks without prodromes) must have had no attacks for 2 years before it is possible to drive again. (2) Patients with vestibular migraine without prodromes must not have had any attacks for 3 years. For a group 1 and group 2 driving licence (“professional driver”): (3) patients with bilateral vestibulopathy as a rule are considered to have a driving disability. Similarly, strict restrictions have been formulated for ocular motor disorders such as downbeat and upbeat nystagmus and for patients with functional (psychosomatic) forms of dizziness such as phobic postural vertigo. The authors represent a working group of the European Dizzynet focusing on the topic “fitness to drive with vertigo and balance disorders”. They agree that European guidelines must be revised and harmonized, for some are too strict and the required dizziness-free intervals are too long; others must be revised, for they are too lax. A common European standard is needed.

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Acknowledgements

We thank Judy Benson for copy-editing the manuscript. We also thank project manager Nina Kallunki from Finnish Menière Association to provide the data of car driving in Menière’s disease. The work was supported by BMBF, IFBLMU and the Hertie Foundation.

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Authors and Affiliations

  1. German Center for Vertigo and Balance Disorders, University Hospital, Ludwig-Maximilians University, Marchioninistr. 15, 81377, Munich, Germany

    Doreen Huppert & Thomas Brandt

  2. Department of Neurology, University Hospital Zurich, University of Zurich, Frauenklinikstrasse 26, 8091, Zurich, Switzerland

    Dominik Straumann

  3. Department of Otorhinolaryngology, Lund University, Lund, Sweden

    Mans Magnusson

  4. Department of Clinical Science, Lund University, Lund, Sweden

    Mans Magnusson

  5. Hearing and Balance Research Unit, Department of Otolaryngology, University of Tampere, Lääkärinkatu 1, Room E222, 33520, Tampere, Finland

    Ilmari Pyykkö

Authors
  1. Doreen Huppert
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  2. Dominik Straumann
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  3. Mans Magnusson
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  4. Ilmari Pyykkö
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  5. Thomas Brandt
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Corresponding author

Correspondence to Doreen Huppert.

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Ethical standard

The study was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki.

Additional information

This manuscript is part of a supplement sponsored by the German Federal Ministry of Education and Research within the funding initiative for integrated research and treatment centers.

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Huppert, D., Straumann, D., Magnusson, M. et al. Dizziness in Europe: from licensed fitness to drive to licence without fitness to drive. J Neurol 265 (Suppl 1), 9–17 (2018). https://doi.org/10.1007/s00415-018-8806-y

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  • DOI: https://doi.org/10.1007/s00415-018-8806-y

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