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Headache (including Migraine)
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Aeromedical Implications
Effect of aviation on condition
- Fatigue
- Operational stresses
Effect of condition on aviation
- Overt incapacitation
- rapid onset without warning
- neurological deficits
- pain
- vomiting
- Subtle incapacitation
- aura
- neurological deficit
- Distraction due to treatment & symptoms
Effect of treatment on aviation
- side-effects including sedation
Approach to medical certification
Based on the condition: any of the following
- Photophobia and/or photopsia
- Phonophobia
- Dysphasia
- Other sensory features
- Other motor features
- Disabling pain
- Vomiting
- Rate of onset less than 30 mins
Based on Treatment
- Manage effectively with preventative treatment
- Absence of side-effects
Demonstrated Stability
- Absence of symptoms for 3 months AND
- Stabilised on any preventative medication for that period
Risk assessment protocol - Information required
Initial and follow-up applications require you to complete Form 421 Headache Report.
Indicative outcomes
- In combination with a rapid onset, incapacitating or distracting symptoms represent a serious safety risk.
- A period of grounding to demonstrate freedom from severe headaches and the acceptability of any medication will be required.
- Neurological reports will usually be required for commercial pilots, and for private pilots on a case-by-case basis.
- Multi-crew restrictions and passenger-carrying restrictions or other restrictions may be imposed.
Favourable
- Demonstrated absence of severe headaches for a minimum of 3 months
- Acceptable preventative medication eg calcium-channel blockers, beta-blockers, aspirin, AT2 inhibitors if free from side-effects. (NB Beta-blockers carry aerobatic restriction)
- Known and avoidable triggers and sufficient warning of impending episodes
Unfavourable
- Frequent severe headaches and / or neurological symptoms, even if pain-free
- Preventative medication such as tricyclics, ergot derivatives and anticonvulsants
- Severe headaches with other accompanying symptoms
Pilot & Controller Information
- Any recurrence must be reported to the DAME
- Any change of medication must be reported to the DAME
- Multi-crew restrictions and passenger-carrying restrictions or other restrictions may be imposed
Disclaimer
The Clinical Practice Guideline is provided by way of guidance only and subject to the Clinical practice guidelines disclaimer
