Studies indicate that automobile accidents involving drivers diagnosed with MS occur at a higher rate than those involving healthy drivers of the same age. About three times higher, according to early research studies on the subject from Denmark (Lings, 2002) and New Jersey (Schultheis, 2002).
Although the majority of people with MS can drive safely, there are symptoms, such as vision problems, muscle weakness, or spasticity, which can make driving more difficult. During an exacerbation, some people with MS may temporarily give up driving. Others may lose their license if involved in a serious accident.
According to Dr. Akinwuntan in Augusta, Georgia, patients whose level of disability is low, scoring less than 2.5 on the Expanded Disability Status Scale (EDSS), “are relatively good drivers and those above 7 are not fit to drive.” Of course, this is a wide generalization which may not apply to your personal situation.
The EDSS is designed to provide a standardized measurement of global neurological impairment in MS, but is heavily weighted to account for mobility and walking ability. The EDSS is not a good measure of cognitive ability or impairment. Other research has shown that cognitive skills which may be negatively affected in MS can greatly hamper driving ability (Schultheis, 2010).
Common MS symptoms which may affect driving include:
- Sensory (touch) problems such as tingling or numbness in hands and feet
- Visual problems such as blurred or double vision, changes in your visual field or contrast sensitivity, or a temporary loss of sight caused by optic neuritis (inflammation of the optic nerve)
- Fatigue which can make MS symptoms worse
- Loss of muscle strength, control and dexterity
- Problems with walking, balance and coordination
- Muscle spasms and stiffness (spasticity), or paralysis
- Bladder and bowel problems
- Difficulty with memory, concentration, and thinking
The Association for Driver Rehabilitation Specialists offers recommendations to help people with MS stay behind the wheel. Adaptations and changes in habit may be necessary. But first, it is necessary to check the driver’s functional, visual, and cognitive statuses as impairments in each of these areas can make a driver less safe behind the wheel.
Conserving energy is vital for patients who experience decreased energy levels. Energy conservation may require a car lift system to help with storing a wheelchair, or a ramp or mechanical lift for use in a van, truck or SUV. Air conditioning is recommended to help manage cabin temperature for those who are heat sensitive.
Talk to your doctor about the medications you take, especially noting any potential side-effects which could affect your driving. Don’t drive when you are sleepy, drowsy, or just before/after taking medication.
Visual changes may be severe enough for the MS patient to avoid night driving. Sun glasses may be helpful in dimming the glare from the sun. Special mirrors and head turning can compensate for loss of peripheral vision. Know the order of traffic signals so that if your color vision becomes impaired, you will know when to go, stop, or yield. If double vision is a problem, glasses with prisms may be helpful.