Decision Considerations - Aerospace Medical Dispositions
Item 46. Neurologic

General Information

A history or the presence of any neurological condition or disease that potentially may incapacitate an individual should be regarded as initially disqualifying. 

Chronic conditions may be incompatible with safety in aircraft operation because of long-term unpredictability, severe neurologic deficit, or psychological impairment.  

• Symptoms or disturbances that are secondary to the underlying condition that may be acutely incapacitating include pain, weakness, vertigo or incoordination, seizures, disturbance of consciousness, visual disturbance, or mental confusion.
• Numerous neurological conditions may affect equilibrium, resulting in acute incapacitation or varying degrees of chronic recurring spatial disorientation. 

Prophylactic use of medications also may cause recurring spatial disorientation and affect pilot performance. In most instances, further neurological evaluation will be required to determine eligibility for medical certification.

For the majority of neurologic conditions, issuance should be denied or deferred.  Refer to the specific condition disposition for guidance.  Processing can be expedited by including the items listed under Evaluation Data for the corresponding condition. 

If a neurological evaluation is required, it should meet all items on the FAA Specifications for Neurologic Evaluation (PDF).

See below for conditions listed alphabetically by name.

Conditions (A - C)

• Alzheimer’s Disease or Mild Cognitive Impairment (MCI) or Dementia (PDF)
• Amyotrophic Lateral Sclerosis (ALS) (PDF)
• Arteriovenous Malformation (AVM) (PDF)
• Atypical Facial Pain (PDF)
• Bell’s Palsy - (Facial Nerve Palsy, Cranial Nerve Palsy) (PDF)
• Brain Abscess, Encephalitis, Meningitis (PDF)
• Brain Aneurysm (PDF)
• Brain Bleed (PDF)
• Brain Tumors (PDF)
• Central Sleep Apnea (PDF)
• Cerebral Palsy (PDF)
• Chiari Malformation   (PDF)
• Cognitive or Mental Impairment or Dysfunction, Cognitive Disorder, Mild Cognitive Impairment (MCI)  (PDF)
• Concussion  (PDF)

Conditions (D - L)

• Deep Brain Stimulator and Deep Brain Stimulator Status Summary (PDF)
• Dystonia (PDF)
• Epilepsy (See Seizures and Epilepsy (PDF))
• Encephalitis (See Brain Abscess, Encephalitis, Meningitis (PDF))
• Guillain Barre Syndrome (PDF)
• Head Injury or Brain Injury (PDF) - (Concussion, Closed Head Injury, Open Head Injury, and Traumatic Brain Injury)
  • Brain Injury Decision Tool for the AME (PDF)
• Headache or Migraine (PDF) (Cluster, Tension, Ocular, Acephalgic, Ophthalmic, or Retinal)
• Huntington’s Disease (PDF)
• Hydrocephalus (PDF) (with or without shunt)
• Immune-related Demyelinating Disease (PDF)

Conditions (M - R)

• Meningitis (See Brain Abscess, Encephalitis, Meningitis (PDF))
• Myasthenia Gravis (PDF)
• Multiple Sclerosis (PDF)
• Narcolepsy and Idiopathic Hypersomnia (PDF)
• Neurosyphilis (PDF)
• Neuropathy (PDF)
• Neuralgia - (Trigeminal Neuralgia, Post Herpetic Neuralgia) (PDF)
• Neurofibromatosis - (NF-1 von Recklinghausen Disease, NF-2 Wishart Disease) (PDF)
• Optic Neuritis (PDF)
• Orthostatic Hypotension (PDF)
• Paraplegia (PDF)
• Parkinson’s Disease and Parkinsonism (Secondary) (PDF)
• Polio (PDF)
• Pseudotumor Cerebri (PDF)

Conditions (S - Z)

• Seizures or Epilepsy (PDF)
• Slow viral diseases (i.e., Creutzfeldt Jakob’s Disease) (PDF)
• Stroke (CVA) or Transient Ischemic Attack (TIA) (PDF)
• Transient Global Amnesia (TGA) (PDF)
• Tremor (PDF)
• Tourette Syndrome or Tic Disorder (PDF)
• Traumatic Brain Injury (PDF)
• Unexplained Loss of Consciousness (ULOC) (PDF)
• Wilson’s Disease (PDF)