Neurological Assessment for UK Class 1 Medical

[ATCO Wannabe]

Good Day,

I am going to see a Neurologist at the CAA soon with reference to an initial issue of a UK Class 1 medical with a "past" history of migraine, as up to now they have said no.

I am trying to find out what the neurological assessment entails and what to expect.


Any one got any help / information for me?


Im only there for an hour so I guess there cant be too much involved.? can there?

Thanks

[QDMQDMQDM]

The crux of any neurological assessment is the history, so expect to spend a lot of time answering questions. In the diagnosis of migraine the examination plays minimal part and there is unlikely to be an indication for a brain scan of any sort.

Migraine is a vascular phenomenon which may or may not be associated with headache. There are very clear symptoms associated with it and it is very often grossly misdiagnosed. In particular, amongst the general public 'migraine' is taken to be synonymous with 'severe headache'. It is nothing of the sort and I see many people every week who come in and say 'My migraines are terrible, doctor'. Almost invariably, they are suffering from tension headache and they do not appreciate the implications of a migraine diagnosis. In particular, for women such a diagnosis means that the combined contraceptive pill is pretty much contra-indicated. For people who want a class 1 medical it is the kiss of death.

Of the many types of migraine, the commonest is classical migraine. In this variant, a severe one-sided headache with nausea, vomiting and photophobia is preceded by 30-60 minutes by a migrainous aura. This is usually a visual aura, often consisting of zig zag lines in the visual field. The headache can last 24-36 hours, is excruciating and requires the sufferer to lie in a darkened room. Taking a drug of the sumatriptan class during the aura and before the headache can abort the headache. It is rare for migraines to occur more than once a month.

If this sounds like what you get, you might have classical migraine. As I say, there are a number of other migrainous syndromes too and, if you do suffer from migraine, I personally think it is probably correct that you don't get a class 1 for a variety of reasons.

Good luck!

QDM

[Circuit Basher]

[Non-medical comment - QDMcubed is far more knowledgeable than me on these matters!]
ATCO Wannabe - I assume the Class 1 is associated with your nickname, in which case I believe that you'll most likely be struggling to get a Class 1. This is as, of the many possible triggers of migraine, there are flashing lights, stress, tiredness, low oxygen levels; all of which are factors which may well be experienced as an ATCO. This is the thing that the neurologist is likely to focus on.

I recently saw a consultant neurologist privately in relation to headaches (to get confirmation that the headaches I had were migraines) and the general idea was to take a family history, a history of my pattern of headaches, review of lifesyle and a brief physical exam (checking eyesight, peripheral eyesight, reflexes, muscular tone, ability to touch nose with eyes closed, etc). Diagnosis was that I have classical migraine with aura - ergo, RAF will not give me medical category better than A3 (Unfit Solo) for gliding.