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Údarás Um Shábháilteacht Ar Bhóithre Road Safety Authority

Loss of consciousness/loss of or altered awareness22

Excluding Cough Syncope (See Chapter 9)

A full history is imperative to include pre-morbid history, prodromal symptoms, period of time unconscious, degree of amnesia and confusion on recovery. A neurological cause, for example, epilepsy, subarachnoid haemorrhage, can often be identified by the history, examination and the appropriate referral made. The relevant Sláinte agus Tiomáint guidelines will then apply. In 80% of all cases there is a cardiovascular cause and again, these can also be determined by history, examination and ECG. Investigate and treat accordingly and use the relevant Sláinte agus Tiomáint guidelines.

The remaining cases can be classified under five categories in the following table:

Neurological Disorders

Group 1 - Entitlement ODL

Group 2 Entitlement ODL


car, motorcycle and tractor





1. Reflex Vasovagal Syncope

No driving restrictions.

No driving restrictions.

Definite provocational factors



with associated prodromal



symptoms and which are



unlikely to occur whilst sitting or



lying. Benign in nature.



If recurrent, will need to

NDLS need not be informed.

NDLS need not be notified.

check the “3 Ps” apply on



each occasion (provocation/


N.B. Cough Syncope see Chapter 9




(If not see Number 6 below).






2. Solitary loss of consciousness/

No driving restrictions.

Can drive 3 months after the event if

loss of or altered awareness


no further recurrence.

likely to be unexplained syncope

NDLS need not be informed.


but with a high probability of


N.B. Cough Syncope see Chapter 9

reflex vasovagal syncope.



These have no clinical evidence



of structural heart disease and a



normal ECG.






See Appendix at end of this chapter for epilepsy standards.

22. Guzman JC, Morillo CA. Syncope and Driving. Cardiol Clin. 2015, Aug;33(3):465-71.

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