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ICAO Preliminary Unedited Version — October 2008
Part III
Chapter 10. NEUROLOGICAL DISORDERS
Page
Introduction............................................................................................................ III-10-1
Episodic disorders.................................................................................................. III-10-2
Migraine ............................................................................................................III-10-2
Cluster headache................................................................................................III-10-4
Chronic daily headache ..................................................................................... III-10-4
Transient Global Amnesia (TGA)..................................................................... III-10-4
Syncope .............................................................................................................III-10-5
Seizure Disorder ................................................................................................III-10-6
The single seizure.............................................................................................. III-10-8
The screening EEG............................................................................................ III-10-8
Cerebrovascular disease........................................................................................ III-10-8
Ischaemic stroke ................................................................................................III-10-8
Haemorrhagic stroke .........................................................................................III-10-9
Subarachnoid haemorrhage ...............................................................................III-10-10
Traumatic brain injury ......................................................................................... III-10-11
Post-concussion syndrome ................................................................................III-10-11
Focal neurological deficit.................................................................................. III-10-11
Cognitive residual sequelae............................................................................... III-10-11
Post-traumatic epilepsy (PTE)........................................................................... III-10-12
Neoplasms ............................................................................................................... III-10-13
Benign neoplasms..............................................................................................III-10-13
Malignant neoplasms.........................................................................................III-10-13
Hereditary, degenerative and demyelination disorders ..................................... III-10-14
Familial and essential tremor ............................................................................ III-10-14
Parkinson’s disease............................................................................................III-10-14
Multiple sclerosis ..............................................................................................III-10-15
Conclusion .............................................................................................................. III-10-16
Recommended reading .......................................................................................... III-10-16
ICAO Preliminary Unedited Version — October 2008 III-10-1
INTRODUCTION
Given the assumption that an intact and normally functioning nervous system is essential to flight safety,
one might conclude that only the neurologically perfect person should hold an aviation licence. Since the
nervous system is subject to abnormal conditions as are other body systems, not all licence holders are
neurologically perfect. This chapter addresses neurological conditions that might compromise the safety
of flight. Some can be accommodated with or without conditions, while others may preclude medical
certification.
The neurological requirements in Annex 1 are as follows (identical for Class 1, 2 and 3 Medical
Assessments):
6.3.2.3 The applicant shall have no established medical history or clinical diagnosis of any of the following:
a) a progressive or non-progressive disease of the nervous system, the effects of which are likely to interfere
with the safe exercise of the applicant’s licence and rating privileges;
b) epilepsy; or
c) any disturbance of consciousness without satisfactory medical explanation of cause.
6.3.2.4 The applicant shall not have suffered any head injury, the effects of which are likely to interfere with the
safe exercise of the applicant’s licence and rating privileges.
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Manual of Civil Aviation Medicine 2(22)
