2010 BC Guide in Determining Fitness to Drive

Central vestibular disordersThe majority of central vestibular disorders have a persistent impact on driving because theyarise from underlying persistent medical conditions. However, two common causes of centralvestibular disorders - migraines and hyperventilation syndrome - are episodic in nature withshort disease duration.Peripheral vestibular disordersPeripheral vestibular disorders are generally more episodic with, in general, shorter diseaseduration. Drivers, however, with complete bilateral vestibular hypofunction (absence offunction) may have severe and constant disequilibrium and motion sensitivity forever. Thesedrivers may have more difficulty driving, particularly during evening hours or on bumpy roads,and may not be safe to drive.ConditionType ofdrivingimpairmentand assessmentapproachPrimaryfunctionalabilityaffectedAssessment toolsVestibular disorders resultingin episodic impairment,including:migrainespsychogenic vertigo/anxiety (hyperventilationsyndrome)benign paroxysmalpositioning vertigo (BPPV)Meniere’s Diseasevestibular neuronitis(labyrinthitis)Tumarkin’s Otolithic Crisis(drop attacks)Episodicimpairment:Medicalassessment –likelihood ofimpairmentPersistentImpairment:FunctionalassessmentSensorimotorCognitiveDriver’s MedicalExamination ReportSpecialist’s reportDriver’s MedicalExamination ReportCognitive screeningtools such as; MOCA,MMSE, SIMARD-MD,Trails A or BDriveABLE assessment152