ATCO.MED.B.065 Neurology

Regulation (EU) 2015/340

 

(a)       Applicants with an established history or clinical diagnosis of the following shall be assessed as unfit:

(1) epilepsy except in cases in point (b)(1) and (2);

(2) recurring episodes of disturbance of consciousness of uncertain cause;

(3) conditions with a high propensity for cerebral dysfunction.

(b)       Applicants with an established history or clinical diagnosis of the following conditions shall be referred to the licensing authority and undergo further evaluation before a fit assessment may be considered:

(1) epilepsy without recurrence after the age of 5;

(2) epilepsy without recurrence and off all treatment for more than 10 years;

(3) epileptiform EEG abnormalities and focal slow waves;

(4) progressive or non-progressive disease of the nervous system;

(5) a single episode of disturbances or loss of consciousness;

(6) brain injury;

(7) spinal or peripheral nerve injury;

(8) disorders of the nervous system due to vascular deficiencies including hemorrhagic and ischemic events.

 

AMC1 ATCO.MED.B.065 Neurology

                                                                                                                                                                                                                                                                                                                                                                                                                                                              ED Decision 2015/010/R

 

(a)       Electroencephalography (EEG)

(1) EEG should be carried out when indicated by the applicant’s history or on clinical grounds.

(2) Epileptiform paroxysmal EEG abnormalities and focal slow waves should be disqualifying. A fit assessment may be considered after further evaluation.

 

(b)       Epilepsy

(1) Applicants who have experienced one or more convulsive episodes after the age of five should be assessed as unfit.

(2) A fit assessment may be considered if:

(i) the applicant is seizure free and off medication for a period of at least 10 years

(ii) full neurological evaluation shows that a seizure was caused by a specific non-recurrent cause, such as trauma or toxin.

(3) Applicants who have experienced an episode of benign Rolandic seizure may be assessed as fit provided the seizure has been clearly diagnosed including a properly documented history and typical EEG result and the applicant has been free of symptoms and off treatment for at least 10 years.

 

(c)        Neurological disease

Applicants with any stationary or progressive disease of the nervous system which has caused or is likely to cause a significant disability should be assessed as unfit. A fit assessment may be considered after full neurological evaluation in cases of minor functional losses associated with stationary disease.

 

(d)       Disturbance of consciousness

Applicants with a history of one or more episodes of disturbed consciousness may be assessed as fit if the condition can be satisfactorily explained by a non-recurrent cause. A full neurological evaluation is required.

 

(e)       Head injury

Applicants with a head injury which was severe enough to cause loss of consciousness or is associated with penetrating brain injury should be evaluated by a consultant neurologist. A fit assessment may be considered if there has been a full recovery and the risk of epilepsy is sufficiently low. Behavioral and cognitive aspects should be taken into account