Weakness, Pain and Ambulation Difficulty Are Potential Risk Factors for Motor Ve

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Weakness, Pain and Ambulation Difficulty Are Potential Risk Factors

for Motor Vehicle Accidents in Patients with Neuropathy

(ANN April 15, 2008)

Tina N. Nguyen, Anil Rama, San , CA, Hans D. Katzberg,

S. Katz, San Francisco, CA, Yuen T. So, S. Cho, Stanford, CA

OBJECTIVE: To assess potential risk factors associated with motor

vehicle accidents (MVA) in patients with neuropathy.

BACKGROUND: Neuropathy may impair driving. We previously presented

data showing a higher MVA rate in neuropathy patients compared to a

general population control group. However, the nature of driving

dysfunction has not been previously characterized.

DESIGN/METHODS: 260 patients with neurologist s diagnosis of

neuropathy were surveyed from June 2002 to January 2005 with the

Neuropathic Symptom Score (NSS), Medical Research Council (MRC)

sumscore, modified Rankin Disability Score, Brief Pain Inventory,

Gracely Pain Scale, Visual Analogue Score (VAS), and Numeric Pain

Rating Scale (NPRS). Odds ratios and student s T-tests were

performed.

RESULTS: 111 patients (43%) described at least one at-fault accident,

while 149 had no MVA. The crude odds ratio (OR) of having an accident

in patients with severe pain (VAS and NPRS >6) was 4.657 (95% CI =

2.614 to 8.290, p < 0.0005). Mean NPRS score for the group with

accidents was 4.86 compared to 3.15 (p<0.001) in the group without

accidents. The OR of having a MVA among those with ambulation

difficulty and lower Rankin score was 1.990 (95% CI = 1.125 to 3.520,

p < 0.026). Mean MRC sum scores was 25.6 for the group with MVA and

39 for the group without (p<0.005), with the majority of weakness

identified being present in the lower extremities. Sensory and

autonomic symptoms were evenly distributed in the two groups.

CONCLUSIONS/RELEVANCE: Weakness, pain and ambulation difficulty are

associated with increased odds of MVA in patients with neuropathy.

When assessing whether a patient with neuropathy should drive, these

potential risk factors should be taken into consideration.