Physical and Mental Conditions Guidelines Page 4.

3
LAPSE OF CONSCIOUSNESS CONSOLIDATION TABLE

Seizure Type Definition
Simple Partial Implies no loss of
Seizure consciousness. A seizure
discharge confined to a
Usually small area of the brain. The
originates in a person may have twitching
specific focal which may involve the face
point in the or other extremities, slurred
brain. These words, odd smells, strange
seizures spread feelings, visual disturbances.
gradually or
suddenly. An aura is a simple partial
seizure that may precede
other types of seizures.
Functional
Impairment Severity Range
May cause a Minimum: Seizures never
distraction or progress to complex partial
change in sensory seizures or secondarily
motor functions. generalized tonic clonic seizures.
Condition is well controlled with
or without medication with no
adverse side effects. There is no
distraction or significant change
in sensory or motor function
which would likely impair driving
ability.
Maximum: Uncontrollable
frequent episodes in which
muscular control or coordination
of a limb is affected for a period
of time to the point that
maneuvering a motor vehicle is
very difficult.
Episodes with sensory or
emotional impairment which
interfere with attentional process
to an extent that is unsafe to drive.
Range of Actions
No Action: Seizures are stable
and controlled or are ongoing
seizures, i.e., twitch, but do not
affect driving.
Medical Prob. II: Control only
recently achieved for three
months.
Medical Prob. III: Stable and
controlled for six months or
longer with potential for
instability due to contributing
factors.
Suspension: Condition not
controlled and could affect the
driver’s ability to safely operate
a motor vehicle.
Revocation: Condition not likely
to ever be brought under control.
Contributing Factors
• Alcohol consumption
• Evidence of driving under
stressful or fatiguing situations
• Mileage and road exposure
• Sleep deprivation. This could
be caused by illness, studying
for finals, insomnia, newborn,
etc.
• Drug abuse (prescribed or
illicit)
• Etiology
• Change in medical regimen
• Adverse side effects to
anticonvulsant medications.
This could include dizziness,
weakness, tremors, or lack of
alertness and coordination
contributing to poor reaction
time when driving.
• Driver’s reliability and
compliance with prescribed
medical regimen. A person’s
positive attitude toward
understanding and accepting
his/her epileptic condition will
enhance his/her ability to
achieve adequate control of the
condition.
• History of noncompliance with
prior medical probation

Rev. 2-99
Physical and Mental Conditions Guidelines LAPSE OF CONSCIOUSNESS CONSOLIDATION TABLE Page 4.4
Rev. 2/99
Functional
Seizure Type Definition Impairment Severity Range Range of Actions Contributing Factors
Complex Characterized by a lapse of Loss of Minimum: Seizures are well No Action: Condition is stable • Alcohol consumption
Partial Seizure consciousness and may have consciousness or controlled with or without and controlled for an adequate
quasi purposeful movement ability to respond medication with no adverse side period of time. • Evidence of driving under
Usually which may or may not be to the effects. stressful or fatiguing situations
Medical Prob. II: Control only
originates in a reactive to the environment. environment.
recently achieved for three • Mileage and road exposure
specific focal The person usually has no Maximum: Uncontrollable
point in the recollection of events. May have frequent episodes of partial or
months. • Sleep deprivation. This could
brain. These prolonged post- total loss of consciousness. Medical Prob. III: Stable and be caused by illness, studying
seizures spread seizure confusion. controlled for six months or for finals, insomnia, newborn,
gradually or longer with potential for etc.
suddenly. instability due to contributing • Drug abuse (prescribed or
factors. illicit)
Suspension: Condition not • Etiology
controlled and could affect the
driver’s ability to safely operate • Change in medical regimen
a motor vehicle.
• Adverse side effects to
Revocation: Condition not likely anticonvulsant medications.
to ever be brought under control. This could include dizziness,
weakness, tremors, or lack of
alertness and coordination
contributing to poor reaction
time when driving.
• Driver’s reliability and
compliance with prescribed
medical regimen. A person’s
positive attitude toward
understanding and accepting
his/her epileptic condition will
enhance his/her ability to
achieve adequate control of the
condition.
• History of noncompliance with
prior medical probation

Rev. 2-99
Physical and Mental Conditions Guidelines LAPSE OF CONSCIOUSNESS CONSOLIDATION TABLE Page 4.5

Functional
Seizure Type Definition Impairment Severity Range Range of Actions Contributing Factors
Secondarily Starts as a simple partial Involuntary Minimum: Seizures are well No Action: Condition is stable • Alcohol consumption
Generalized seizure or complex partial repetitive controlled with or without and controlled for an adequate
Seizure seizure and develops into a movements. medication with no adverse side period of time. • Evidence of driving under
generalized tonic clonic effects. stressful or fatiguing situations
Medical Prob. II: Control only
Usually seizure. A simple or Loss of
recently achieved for three • Mileage and road exposure
originates in a complex partial seizure can consciousness. Maximum: Uncontrollable,
specific focal both progress to a frequent episodes of partial or
months. • Sleep deprivation. This could
point in the secondarily generalized Prolonged post- total loss of consciousness. Medical Prob. III: Stable and be caused by illness, studying
brain. These seizure. seizure confusion. controlled for six months or for finals, insomnia, newborn,
seizures spread longer with potential for etc.
gradually or instability due to contributing • Drug abuse (prescribed or
suddenly. factors. illicit)
Suspension: Condition not • Etiology
controlled and could affect the
driver’s ability to safely operate • Change in medical regimen
a motor vehicle.
• Adverse side effects to
Revocation: Condition not likely anticonvulsant medications.
to ever be brought under control. This could include dizziness,
weakness, tremors, or lack of
alertness and coordination
contributing to poor reaction
time when driving.
• Driver’s reliability and
compliance with prescribed
medical regimen. A person’s
positive attitude toward
understanding and accepting
his/her epileptic condition will
enhance his/her ability to
achieve adequate control of the
condition.
• History of noncompliance with
prior medical probation

Rev. 2-99
Physical and Mental Conditions Guidelines
Seizure Type Definition
Absence (Petit Characterized by a lapse of
mal) consciousness which begins
and ends abruptly without
Usually any post-seizure confusion.
originates in a
specific focal These seizures are
point in the sometimes manifested by
brain. These staring spells, lip smacking,
seizures spread interrupted speaking. Also
gradually or described a momentary
suddenly. trance.
Absence seizures must be
distinguished from complex
partial seizures, the latter of
which are prolonged and
have post-seizure confusion.
Rev. 2-99
LAPSE OF CONSCIOUSNESS CONSOLIDATION TABLE Page 4.6
Functional
Impairment Severity Range Range of Actions Contributing Factors
Loss of Minimum: Seizures are well No Action: Condition is stable • Alcohol consumption
consciousness or controlled with or without and controlled for an adequate
awareness of medication with no adverse side period of time. • Evidence of driving under
surroundings. effects. stressful or fatiguing situations
Medical Prob. II: Control only
Begins and ends
recently achieved for three • Mileage and road exposure
abuptly. Maximum: Uncontrollable
frequent episodes of loss of
months. • Sleep deprivation. This could
consciousness. Medical Prob. III: Stable and be caused by illness, studying
controlled for six months or for finals, insomnia, newborn,
Frequent inability to respond longer with potential for etc.
appropriately and rapidly to instability due to contributing • Drug abuse (prescribed or
traffic situations. factors. illicit)
Suspension: Condition not • Etiology
controlled and could affect the
• Change in medical regimen
driver’s ability to safely operate
a motor vehicle.
• Adverse side effects to
Revocation: Condition not likely anticonvulsant medications.
to ever be brought under control. This could include dizziness,
weakness, tremors, or lack of
alertness and coordination
contributing to poor reaction
time when driving.
• Driver’s reliability and
compliance with prescribed
medical regimen. A person’s
positive attitude toward
understanding and accepting
his/her epileptic condition will
enhance his/her ability to
achieve adequate control of the
condition.
• History of noncompliance with
prior medical probation
Physical and Mental Conditions Guidelines LAPSE OF CONSCIOUSNESS CONSOLIDATION TABLE Page 4.7

Functional
Seizure Type Definition Impairment Severity Range Range of Actions Contributing Factors
Tonic Clonic Convulsion, characterized Involuntary Minimum: Seizures are well No Action: Condition is stable • Alcohol consumption
(Grand mal) by stiffening and jerking of repetitive controlled with or without and controlled for an adequate
the whole body. movements. medication with no adverse side period of time. • Evidence of driving under
Usually effects. stressful or fatiguing situations
Medical Prob. II: Control only
originates in a Loss of
recently achieved for three • Mileage and road exposure
specific focal consciousness. Maximum: Uncontrollable,
point in the frequent episodes of loss of
months. • Sleep deprivation. This could
brain. These Prolonged post consciousness in conjunction with Medical Prob. III: Stable and be caused by illness, studying
seizures spread seizure confusion. convulsive movement. controlled for six months or for finals, insomnia, newborn,
gradually or longer with potential for etc.
suddenly. instability due to contributing • Drug abuse (prescribed or
factors. illicit)
Suspension: Condition not • Etiology
controlled and could affect the
driver’s ability to safely operate • Change in medical regimen
a motor vehicle.
• Adverse side effects to
Revocation: Condition not likely anticonvulsant medications.
to ever be brought under control. This could include dizziness,
weakness, tremors, or lack of
alertness and coordination
contributing to poor reaction
time when driving.
• Driver’s reliability and
compliance with prescribed
medical regimen. A person’s
positive attitude toward
understanding and accepting
his/her epileptic condition will
enhance his/her ability to
achieve adequate control of the
condition.
• History of noncompliance with
prior medical probation

Rev. 2-99
Physical and Mental Conditions Guidelines LAPSE OF CONSCIOUSNESS CONSOLIDATION TABLE Page 4.8

Functional
Seizure Type Definition Impairment Severity Range Range of Actions Contributing Factors
Tonic Muscle stiffening or Involuntary Minimum: Seizures are well No Action: Condition is stable • Alcohol consumption
sustained contraction. repetitive controlled with or without and controlled for an adequate
movements. Loss medication with no adverse side period of time. • Evidence of driving under
of consciousness. effects. stressful or fatiguing situations
Clonic Repetitive jerking of Prolonged post- Medical Prob. II: Control only • Mileage and road exposure
muscles. seizure confusion. Maximum: Uncontrollable recently achieved for three
frequent episodes of loss of months. • Sleep deprivation. This could
consciousness in conjunction with be caused by illness, studying
Medical Prob. III: Stable and for finals, insomnia, newborn,
convulsive movement.
controlled for six months or etc.
Atonic Loss of muscle tone. Sudden loss of Minimum: Seizures are well longer with potential for • Drug abuse (prescribed or
muscle tone. controlled with or without instability due to contributing illicit)
Cannot maintain medication with no adverse side factors.
posture. Will have effects. • Etiology
Suspension: Condition not
drop attacks.
controlled and could affect the • Change in medical regimen
Maximum: Uncontrollable
frequent drop attacks.
driver’s ability to safely operate • Adverse side effects to
a motor vehicle. anticonvulsant medications.
Revocation: Condition not likely This could include dizziness,
to ever be brought under control. weakness, tremors, or lack of
alertness and coordination
contributing to poor reaction
time when driving.
• Driver’s reliability and
compliance with prescribed
medical regimen. A person’s
positive attitude toward
understanding and accepting
his/her epileptic condition will
enhance his/her ability to
achieve adequate control of the
condition.
History of noncompliance with
prior medical probation

Rev. 2-99
Physical and Mental Conditions Guidelines LAPSE OF CONSCIOUSNESS CONSOLIDATION TABLE Page 4.9

Functional
Seizure Type Definition Impairment Severity Range Range of Actions Contributing Factors
Myoclonic Rhythmic muscle Rhythmic muscle Minimum: Seizures are well No Action: Seizures are stable and • Alcohol consumption
contractions, contractions, controlled with or without controlled or are ongoing seizures, i.e.,
Usually twitching or spasm. twitching or spasm medication with no adverse twitch, but do not affect driving. • Evidence of driving under
originates in a with no loss of side effects. stressful or fatiguing situations
Medical Prob. II: Control only recently
specific focal consciousness.
achieved for three months. • Mileage and road exposure
point in the Maximum: Frequent muscle
brain. These jerks which would interfere Medical Prob. III: Stable and controlled for • Sleep deprivation. This could
seizures spread with driving ability. six months or longer with potential for be caused by illness, studying
gradually or instability due to contributing factors. for finals, insomnia, newborn,
suddenly. etc.
Suspension: Condition not controlled and
could affect the driver’s ability to safely • Drug abuse (prescribed or
operate a motor vehicle. illicit)

Revocation: Condition not likely to ever be • Etiology

brought under control.
Nocturnal Recurrent seizures These seizures Not applicable. If nocturnal Medical Prob. II: No seizure-free period is
that occur during occur during sleep seizures develop into diurnal required to place the driver on probation
sleep. only. seizures, refer to seizure type when seizures are nocturnal only. These
for severity ranges. drivers should be monitored by probation.
Medical Prob. III: If a driver has been on
Medical Probation Type II for at least six
months, and no further seizure activity has
occurred, conversion to Probation Type III
is appropriate.
Suspension:Not necessary for nocturnal
seizures.
Revocation: Not necessary for nocturnal
seizures.
• Change in medical regimen
• Adverse side effects to
anticonvulsant medications.
This could include dizziness,
weakness, tremors, or lack of
• alertness and coordination
contributing to poor reaction
time when driving.
• Driver’s reliability and
compliance with prescribed
medical regimen. A person’s
positive attitude toward
understanding and accepting
his/her epileptic condition will
enhance his/her ability to
achieve adequate control of the
condition.
• History of noncompliance with
prior medical probation

Rev. 2-99
Physical and Mental Conditions Guidelines
Seizure Type Definition
Syncope Fainting or loss of Loss of conscious-
consciousness due to loss of ness with loss of
cardiac output. muscle tone.
• Situational: Cough,
emotion or during
urination
(micturitional).
• Cardiogenic decrease of
cardiac output
secondary to a rhythm
disturbance or failed
pump.
• Vasovagal or
vasodepressor:
Precipitated by fright or
pain.
Rev. 2-99
LAPSE OF CONSCIOUSNESS CONSOLIDATION TABLE
Functional
Impairment Severity Range
Minimum: Condition causing
syncope has been controlled and
is not likely to recur while
driving.
Maximum: Condition causing
syncope is uncontrollable
resulting in frequent episodes of
loss of consciousness.
Range of Actions
No Action: Single episode
symptomatic to another situation
which is unlikely to recur while
driving:
• Situational (vasovagal): An
example of this would be
when a person faints at the
sight of blood.
• Cardiogenic: Disorder
controlled as determined by
the physician.
Medical Prob. II: Control only
recently achieved for three
months.
Medical Prob. III: Stable and
controlled for six months or
longer with potential for
instability due to contributing
factors.
Suspension: Fainting likely to
recur because precipitating
condition is not controlled.
Revocation: Precipitating
condition not likely to ever be
brought under control.
Page 4.10
Contributing Factors
• Alcohol consumption
• Evidence of driving under
stressful or fatiguing situations
• Mileage and road exposure
• Sleep deprivation. This could
be caused by illness, studying
for finals, insomnia, newborn,
etc.
• Drug abuse (prescribed or
illicit)
• Etiology
• Change in medical regimen
• Adverse side effects to
medications.
• Driver’s reliability and
compliance with prescribed
medical regimen. A person’s
positive attitude toward
understanding and accepting
his/her epileptic condition will
enhance his/her ability to
achieve adequate control of the
condition.
• History of noncompliance with
prior medical probation
Physical and Mental Conditions Guidelines LAPSE OF CONSCIOUSNESS CONSOLIDATION TABLE Page 4.11

Functional
Seizure Type Definition Impairment Severity Range Range of Actions Contributing Factors
Narcolepsy A condition in which there Cataplexy: Loss Minimum: Condition causing No Action: Stable and controlled • Alcohol consumption
is sudden loss of muscle of muscular tone Cataplexy has been controlled and so that it does not affect driving.
Cataplexy tone following emotional and inability to is not likely to recur. Daytime • Evidence of driving under
Medical Prob. II: Control only stressful or fatiguing situations
change or shock. maintain posture. sleepiness is controlled.
recently achieved for three
Sleep Apnea Drop attacks.
months. • Mileage and road exposure
Cataplexy may cause a Maximum: Uncontrolled episode
Other Sleep person to fall to the floor but Narcolepsy: of loss of awareness of Medical Prob. III: Stable and • Drug abuse (prescribed or
Disorders consciousness will not be Excessive daytime surroundings. controlled for six months or illicit)
lost. Usually seen in sleepiness. longer with potential for • Etiology
narcolepsy. Loss of feeling in limbs, hands, instability due to contributing
Sleep Apnea: and feet or muscular control is factors. • Change in medical regimen
Excessive daytime affected to the point that • Adverse side effects to
Suspension: Uncontrolled
sleepiness. maneuvering vehicle is difficult. medications.
pathological sleep which could
Uncontrollable
affect the ability to safely
urge to sleep at Inability to maintain posture; • Driver’s reliability and
operate a motor vehicle.
irregular intervals. extreme muscular weakness which compliance with prescribed
impairs one’s ability to operate a Revocation: Condition not likely medical regimen. A person’s
motor vehicle. to ever be brought under control. positive attitude toward
understanding and accepting
his/her epileptic condition will
enhance his/her ability to
achieve adequate control of the
condition.
• History of noncompliance with
prior medical probation

Rev. 2-99
Physical and Mental Conditions Guidelines
Seizure Type Definition
Symptomatic Seizures resulting from a
known structural brain
abnormality or other
medical conditions such as
severe sleep deprivation,
brain tumor, stroke*, or
pregnancy.
*NOTE: When a person
experiences a lapse of
consciousness due to a
stroke, there may be residual
multi-infarct dementia.
Refer to the section on
Dementia.
Metabolic Seizures resulting from
imbalanced chemical and
physical processes occurring
in the body. For example:
• Hypoglycemia: Low
blood sugar
• Hyponatremia: Low
blood sugar
• Hypoxia: Low levels of
oxygen
Toxic Substance abuse involving:
1. Alcohol withdrawal
2. Drug use (illicit or
prescribed)
Rev. 2-99
LAPSE OF CONSCIOUSNESS CONSOLIDATION TABLE
Functional
Impairment Severity Range
See episode type. Minimum: Episodes are limited to
a few seconds with no loss of
consciousness. Loss of muscular
control and coordination must be
minimal. Awareness of the
environment must not be lost.
Maximum: Loss of muscle control
and/or awareness of the
environment.
See seizure type Minimum: Episodes are limited to
a few seconds and no loss of
consciousness is experienced.
Loss of muscular control and
coordination must be minimal to
the point that physical control of a
motor vehicle can be maintained.
Awareness of the environment
must not be lost.
Interference with Same as Symptomatic.
awareness and
muscular control
or coordination or
possible loss of
consciousness.
Range of Actions
Refer to the type of seizures
experienced.
Refer to the type of seizure
experienced.
Refer to the type of seizure
experienced.
Page 4.12
Contributing Factors
• Alcohol consumption
• Evidence of driving under
stressful or fatiguing situations
• Mileage and road exposure
• Drug abuse (prescribed or
illicit)
• Etiology
• Change in medical regimen
• Adverse side effects to
medications.
• Driver’s reliability and
compliance with prescribed
medical regimen. A person’s
positive attitude toward
understanding and accepting
his/her epileptic condition will
enhance his/her ability to
achieve adequate control of the
condition.
• History of noncompliance with
prior medical probation