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Stroke and transient ischaemic attack - Management
What should I advise about driving after a stroke or transient ischaemic attack?
- Always consult the latest Driver and Vehicle Licensing Agency (DVLA) regulations to ensure that your advice is accurate and up to date — see the 'At a Glance' booklet available on the DVLA website.
- For people with a group II licence — for large goods vehicles or passenger carrying vehicles — who have had a stroke or TIA:
- They must notify the DVLA, who will not allow them to drive under this licence for at least 12 months.
- They can be considered for re-licensing after this period provided that they have no residual impairment likely to affect safe driving and no other significant risk factors.
- Re-licensing will also be subject to satisfactory medical reports, including exercise electrocardiography.
- Where there is imaging evidence of essentially normal carotid arteries Group 2 licensing may be allowed without the need for functional cardiac assessment.
- For people with a group I licence — an ordinary driving licence for car or motorcycle — who have had a stroke or TIA:
- They must not drive for at least 4 weeks.
- They may resume driving after this period if clinical recovery is satisfactory.
- There is no need to notify the DVLA unless there is residual neurological deficit 1 month after the episode: for example, visual field defects, cognitive defects, and impaired limb function:
- Minor limb weakness alone does not require notification unless the person is restricted to driving certain types of vehicle or vehicles with adapted controls.
- Vehicle adaptations may be able to overcome severe physical impairment.
- The DVLA will need to know which, if any, of the controls require modification and will ask the person to complete a simple questionnaire. The driving licence will then be coded to reflect the modifications.
- People who have multiple TIAs over a short period should notify the DVLA of this; the DVLA will require at least 3 months free of further attacks before allowing driving to be resumed.
- For all people (group I or II licence) who wish to resuming driving after recovering from a stroke or TIA:
- They will need to be assessed for factors that preclude safe driving. These factors include:
- Significant visual field defect or reduction in visual acuity.
- An epileptic seizure within the past 12 months (a seizure within the first 24 hours after the onset of the stroke is considered to be a provoked seizure, not an epileptic seizure).
- A disorder of focused attention, especially hemi-spatial neglect.
- They will need sufficient muscle control to control their car (which may require adaptations).
- They will need sufficient cognitive ability to drive safely on a busy road. On-the-road assessment of ability may be required because assessment in the clinic is inaccurate.
- Advice on mechanical adaptations can be obtained from a number of sources, including the DVLA.
- They can get computer-based driving training and should consider having driving skills reassessed.
- They should inform their car insurance company before resuming driving, as failure to do so could result in the insurance being void.
Basis for recommendation
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