Epilepsy vs. crashes: Not easy to prove!

On a fall day more than 16 years ago, Terry L. Thomas' car crossed the centerline on Kenny Road and crashed into a line of stopped traffic.

A noted Ohio State University cancer specialist, Dr. John P. Minton, died in the crash, which was later linked to an epileptic seizure suffered by Thomas.

Last week, Thomas, 59, of 3093 Wareham Rd. in Upper Arlington, was involved in a similar crash on Worthington-Galena Road. Early on March 27, his car crossed the centerline and shot into a stand of trees.

This time, he lost his own life.

It might never be known whether the epilepsy cited in the crash that killed Minton played a role in Thomas' own death.

Investigators suspect the medical condition was involved, but Franklin County Coroner Brad Lewis said no forensic evidence would prove it.

"That is a very hard thing to pick out," he said.

Dr. J. Layne Moore, an associate professor of clinical neurology who runs Ohio State University's comprehensive epilepsy program, said the only physical evidence of seizures typically is incontinence or tongue-biting. Either of those conditions also could occur in a fatal car crash.
"Unless you've got a witness to the seizure, I wouldn't think you can tell anything from the body," he said.

Thomas was charged with vehicular homicide in Minton's death and pleaded guilty in 1991 to a lesser charge. A judge sentenced him to community service and banned him from driving until he was medically cleared.

Epilepsy isn't a disease but a neurological condition in which electrical imbalances in the brain can trigger seizures. Though surgery sometimes can halt the seizures, a cure doesn't exist for most patients. But experts say that, when properly medicated and treated, people with epilepsy can live normal, productive lives that include safe driving.

In Ohio, people applying for a driver's license must say whether they have a condition that would impair their driving. If they do, they must submit a medical statement showing that they are fit to drive. If they aren't, the Bureau of Motor Vehicles may restrict their driving or suspend privileges entirely. Their status is reviewed periodically.

Bureau records show that, when he died, Thomas had a valid license. The only listed restriction was corrective lenses. The status of his epilepsy and any treatment he may have been receiving is unclear. Messages left for relatives at his home were not returned, and the state does not release personal medical information.

Thomas' driving record shows two convictions for failure to control a vehicle, in 2003 and 2005, and one for failure to maintain assured clear distance in 1998. Two of those cases involved accidents.

Moore, who did not treat Thomas, said Ohio does not have a law requiring doctors to inform the state about a patient who has epilepsy. He said the key is to build enough trust with patients to make them realize when they shouldn't drive.

"I tell them that they're not allowed to drive, that they might hurt themselves or hurt other people," he said. "I tell them that I want them to live until they're 80, to resent me."

Moore said most doctors agree that a person who hasn't had a seizure in six months is safe to drive. In a study published in 2004, Maryland researchers found that during one two-year stretch, 0.2 percent of U.S. traffic fatalities involved seizures.

An epileptic driver involved in an accident "may have misrepresented that he had seizures, he may have thought he wasn't having any, or he may have been noncompliant and he may have skipped doses," Moore said.

"They generally do really well, if they're well-controlled," he said.