Page 63 - LECTURETTE TOPICS eBOOK

make him consult his doctor, should normally be a cause for rejection. Even

a single attack of migraine with visual disturbance or ‘Migrainous epilepsy’ is
a bar to acceptance.

Fits and convulsions. History of epilepsy in a candidate is a cause for

rejection. Convulsions/fits after the age of five are also a cause for rejection.
Convulsions in infancy may not be of ominous nature provided it appears

that the convulsions were febrile convulsions and were not associated with
any overt neurological deficit. Causes of epilepsy include genetic factors,

traumatic brain injury, stroke, infection, demyelinating and degenerative
disorders, birth defects, substance abuse and withdrawal seizures. Enquiry

should not be limited only to the occurrence of major attacks. Complex
Partial seizures may masquerade as “faints” and therefore the frequency and

the conditions under which “faints” took place must be elicited. Such attacks
indicate unsuitability for flying, whatever their apparent nature. An isolated
fainting attack calls for enquiry into all the attendant factors to distinguish

between syncope and seizures. For e.g. fainting in school is of common

occurrence and may have little significance. Other complex partial seizures
may manifest as vegetative movements as lip smacking, chewing, staring,
dazed appearance and periods of unresponsiveness. In any event, a

prolonged period of freedom from recurrence must have elapsed before

fitness for flying duties can be considered and if the electroencephalogram
does not show any specific abnormality.

Heat stroke. History of repeated attacks of heat stroke, hyperpyrexia or heat

exhaustion bars employment for duties, as it is an evidence of a faulty heat
regulating mechanism. A single severe attack of heat effects, provided the
history of exposure was severe, and no permanent sequelae were evident is,

by itself, not a reason for rejecting the candidate.

Head Injury or Concussion. A history of severe head injury is a cause for

rejection. The degree of severity may be gauged from the history of duration
of Post Traumatic Amnesia (PTA). Mild brain injury is associated with 0-1

hour PTA, moderate with 1 – 24 hours PTA, severe with 1-7 days PTA and
very severe with > 7 days of PTA. Other sequalae of head injury are post

concussion syndrome which has subjective symptoms of headache,

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