Multiple Sclerosis and Managing to Drive

Is It Possible for a Person to Drive With Multiple Sclerosis?

Yes, many individuals with MS can drive safely, and in fact, people with MS continue driving safely with proper monitoring and support. However, a few considerations must be taken into account. Since there is variability in the symptoms that appear in different individuals, and even the regulations of other states in the United States (U.S.) vary, most regulations suggest disclosing conditions that can affect driving ability. Multiple sclerosis is one of the conditions among them.

Does Having MS Restrict Someone From Driving?

Multiple sclerosis does not directly disqualify a person from driving; instead, it can restrict their ability to drive based on the severity and symptoms of their condition. Therefore, MS driving considerations include undergoing periodic assessments to determine if you can drive safely or not. If you can drive safely, vehicle adaptations may be considered (special mirrors, power steering, hand controls, etc.).

Since symptoms vary among individuals, some may experience less difficulty while driving, while others may have to stop driving altogether. A few driving challenges associated with MS include visual disturbances, spasms, cognitive problems, tingling or numbness in the hands, muscle weakness, and fatigue, which can all impact driving ability.

What Driving Restrictions Apply to Someone With MS?

MS driving restrictions depend on their symptoms and the severity of the disease.

Some restrictions include:

• Individuals have to inform their licensing authority about their health. The frequency of medical reviews depends on the severity of the disease.

• Individuals with MS should undergo specialized driving assessments.

• In cases of vision issues, MS individuals may need to limit their driving to daylight hours. Driving at night can be a challenging issue for individuals with MS.

• Some may have to undergo vehicle modification to enhance their comfort.

• In the event of progressive symptoms, the individual may need to stop driving altogether. Additionally, in case of uncontrolled seizures, cognitive difficulties, physical disabilities, vision issues, and fatigue can further restrict driving.

What Are the Symptoms of Multiple Sclerosis That Affect Driving Ability?

Symptoms of MS may negatively affect an individual's driving ability.

These include:

• Facing difficulty getting in as well as out of the vehicle because of muscle spasms or stiffness.

• Changing gears by moving the foot may be difficult.

• Muscle problems, such as spasms, stiffness, or pain in the arms or right foot.

• There may be a loss of sensation in the feet or hands.

• Coordination may be impaired.

• There may be a slowed reaction time.

• Presence of weakness or fatigue.

• Presence of seizures or loss of consciousness.

• Problems of vision such as blurred vision, double vision, blind spots, or loss of color vision.

• Cognitive impairment-related problems include short-term memory loss, forgetting one's destination, disorientation, confusion, decreased concentration, difficulty with multitasking, and others.

• Mood changes include depression or difficulty controlling anger.

• Some side effects of the medications.

Although the symptoms are mild and manageable, certain actions, such as automobile crashes or near misses, the unwillingness of passengers, and moving violations, suggest that the person’s driving ability is compromised. Some may find difficulty driving whenever there is an MS attack or exacerbation. After the attacks are over, they will be able to drive. Some may permanently lose their driving ability. A study done in 2021 suggested that an individual with MS may have an increased risk of traffic accidents.

What Are the Evaluations Done to Retain the Driving License?

Evaluation is conducted in the driver rehabilitation clinic by an occupational therapist, specifically a driver rehabilitation specialist (DRS). There are two types of evaluations.

These are

• In-office-based assessments.

• Behind-the-wheel evaluations.

1. In-office evaluations: In this type of evaluation, they try to assess:

• An individual’s ability to do daily activities like bathing, dressing, and managing medications.

• They review an individual’s medical and driving history.

• They try to learn about the problems they face while driving.

• Gather information about the receipt of any tickets, accidents, or near misses on the road.

• The DRS assesses for vision (they measure the acuity of the vision, color vision, depth vision, and the ability of a person to identify road signs), cognition (DRS looks for speed of processing of information, visual-spatial skills, and memory), and functions (DRS checks for strength, coordination, and skills related to a person's driving). Only if the DRS findings are satisfactory will further evaluation be done.

2. Behind-the-wheel evaluations: This evaluation is done in a traffic area. This road test checks:

• The ability of the person to follow the rules of the road.

• About safety awareness while driving.

• The ability of a person to move in and out of the vehicle safely or to place a wheelchair inside if necessary.

3. Considering adaptive equipment: After the evaluation at the rehabilitation clinic, the DRS may suggest specialized adaptive equipment for the vehicle.

These include:

• Adapted mirrors.

• A spinner knob that can help turn the steering wheel.

• Adaptive steering and braking require less effort.

• Hand control to change the gas and brake foot pedals.

• Specialized seats to facilitate easy vehicle transfer.

• Lifts that help store wheelchairs and other devices easily.

After all these evaluations, the person must pass another road test with their local Department of Motor Vehicles (DMV). This test assesses their ability to use adaptive equipment safely.

Some more tips for a person with MS for safer driving include:

• Avoid driving when the person affected feels sick or down. The reason for this may be that other illnesses can worsen MS.

• Avoid all distractions while driving. These may include avoiding the phone and radio and asking others in the car to keep their conversation light.

• Avoid driving in heavy traffic areas.

• Bad weather should be avoided while planning a drive.

• If the person tends to get tired easily, then keeping the drive for short distances can help.

• A cooling vest will be carried along if the person is intolerant of heat.

If the person is restricted from driving, they can seek help from others and travel only as a passenger.

Conclusion:

Driving is often considered a sign of independence. Giving up freedom may be difficult for a person. Driving with MS requires awareness of how your symptoms might affect your ability to drive safely. Professional assessments and the use of specialized equipment may help extend driving for some individuals for longer periods. These things also help achieve safe driving and independence. If the person is considered unable to drive anymore, the transition may be hard to accept, but other alternatives should be explored and considered. Hence, knowing about MS, its symptoms, evaluations, and specialized adaptive equipment becomes important.

Key Takeaways:

• Driving can be difficult for people who have MS, but they can still drive safely if they get the right help from their doctor and add special tools to their car.

• Studies show that some people with MS have a hard time driving. When they take a real driving test, about 6 to 38 out of every 100 people don’t pass, which means driving can be challenging for them.

If you or someone you love has MS and wants exceptional help, especially about driving, please talk to our iCliniq neurologist. They can give the right advice!