Prohphylactic anticonvulsant medication tapered off post CVA

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Prohphylactic anticonvulsant medication tapered off post CVA

Post by docrja » Tue Jul 01, 2014 4:03 pm

See FMCSA 2008 Expert Panel Recommendations for Stroke/Neurological

Just examined a 45 y/o male returning to CDL service 1 yr. after elective PFO closure by catheter , after a 2009 CVA. Records 2009 2014 show original LOC was syncope from the CVA, and not seizure but he was maintained on lamotrigine until last year. I have all the medical records.

He meets the requirements for CDL since there is no FMCSA waiting period I know of for prophylactic anticonvulsant. The exam and the CVA is now acceptable and he passed a Road Test for his DL51 on his own by going to his own doctors for the DL51

Exam shows very mild dysarthria in speech (slurs some words but no aphasia or cognitive dysfunction) which is stable on 2 RTW exams here within 6 months, but intact neurological exam otherwise, and cleared by neurologist already.


Is there a recommended waiting period for tapering off "prophylactic anticonvulsant, and if so, how long?

Thanks to all.

Robert Swotinsky MD
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Re: Prohphylactic anticonvulsant medication tapered off post

Post by Robert Swotinsky MD » Fri Jul 04, 2014 4:43 pm

FMCSA does not impose a waiting period before one can drive after stopping seizure medications prescribed for reasons other than seizures. That is, there is no seizure-related requirement, and likely no requirement at all, to withhold certification after stopping the drug in this setting.

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