Commentary : Landmark Case Is a Giant Step Backward : Epilepsy: Many people still link the disease to insanity, violence, lack of intelligence, even possession by demons<i> .</i>

In a so-called landmark case, jurors recently held a local neurologist responsible--to the tune of $3.14 million--for his epileptic patient’s auto accident. What may be considered landmark by some, especially the plaintiff’s attorney, actually represents a giant step backward for my son and the other 2 million or more Americans (23,000 in San Diego County alone) who have epilepsy.

As a group, people with epilepsy (please do not categorize them as epileptics) have had to fight and claw their way out of the dark ages of public misinformation and superstition. This verdict, which is full of flaws anyway, promises to set them back considerably in this county, state, even nation.

And the timing couldn’t be worse for my son Matt, who looks forward to applying for his driver’s license on his 16th birthday next month. Before this case reached the courts and the media, we assumed the license was practically in his wallet.

After two nightmare years of trying five different anticonvulsants, Matt now takes a medication that has controlled his seizures for 26 months--a good 20 months longer than the standard generally applied by the California Department of Motor Vehicles.

We understood the licensing process might take a little longer for Matt because the DMV would contact his neurologist and possibly require an interview before granting a license. Now, thanks to the chilling effect that this case is bound to have on everyone involved, the process might take a lot longer or stall completely.

As parents, we add this new concern about a driver’s license to all our other fears about his future. In this so-called Age of Information, many people still link epilepsy to insanity, violence, lack of intelligence, even possession by demons.

We are not alone in our concern about the right to drive, says Margaret Holt, executive director of the Epilepsy Society of San Diego. She reports a dramatic increase in phone calls from people in a panic over their own driving future in this transportation wasteland.

“The natural fallout from this verdict will be that everyone involved will exercise extreme caution,” Holt says.

Holt fears that this verdict may even lead us back to a time when there was a mandatory three-year waiting period in California for anyone with a seizure disorder. Such a lengthy waiting period makes no sense at a time when the vast majority of people with epilepsy can expect to have their seizures controlled completely by modern medication.

We can only hope that the DMV will continue to look at the individual rather than the category, while also taking into account the relevant accident statistics. According to a survey of traffic accidents in the United States and Western Europe, conducted by Dr. James A. Trostle of UC Berkeley, people with epilepsy have no greater risk of being involved in auto accidents than people with heart disease, stroke, diabetes and alcoholism. The only reason Trostle can find for stricter regulations for people with epilepsy is lingering social discrimination.

One of his most interesting findings is that only 27% of the auto accidents involving people with epilepsy were actually caused by seizures. In this local case, there is serious doubt about whether 18-year-old Trudy Stevenson’s epilepsy had anything to do with her accident.

Although her attorney spent an inordinate amount of trial time trying to prove a seizure caused the accident, the jury remained unconvinced. How, then, can they possibly hold her neurologist accountable for the accident? Have we gone so far beyond the notion of personal responsibility that a doctor can be held liable for every action his patient takes?

Take that “logic” a little further, and the optometrist is responsible for his patient who fails to wear prescription eyeglasses while at the wheel, the cellular telephone manufacturer for the driver who fails to pay attention while dialing, the cosmetic company for the woman putting on her mascara in the rear-view mirror.

The logical lapses in this “landmark” verdict should be exposed in the planned appeal, but that will not be in time for Matt’s birthday. So far, he’s faced seizures, medication changes, regular blood drawings, hospital stays and one diagnostic test after another with surprising equanimity. We hope this verdict won’t make him face being one of the only 16-year-olds in Southern California who can’t drive.