Manual of the Medical Department (NAVMED P-117): Chapter 15: Medical Examinations: Physical Standards

15-53 Neurological Disorders

Department of the Navy
Bureau of Medicine and Surgery

(a) Any condition regardless of cause that:

(1 ) Impairs cognitive judgment or sensory or motor function.

(2) Results in incapacitating or recurrent pain or disturbance of consciousness, or equilibrium.

(b) Cerebrovascular conditions. Any history of cerebral embolism, vascular insufficiency, thrombosis, hemorrhage, arteriosclerosis, arteriovenous malformation, or aneurysm involving the central nervous system.

(c) Congenital malformations associated with neurological manifestations if likely to interfere with normal function or if expected to be progressive; meningocele even if uncomplicated.

(d) Degenerative disorders

(1) Basal ganglia disease.

(2) Cerebellar and Friedreich's ataxia.

(3) Dementia or organic brain syndrome.

(4) Multiple sclerosis or other demyelinating pro

Neurological

Disorders

(5) Muscular atrophies and dystrophies of any (6) Myotonias and myopathies.

(e) Headaches if they are of sufficient severity or frequency to interfere with normal function.

(f)Head injury.

(1) Applicants with a history of head injury with any of the following complications are unacceptable at any time:

(a) Late post traumatic epilepsy manifested by generalized or focal seizure, or multiple early post traumatic seizures.

(b) Transient or persistent neurological deficits indicative of parenchymal central nervous system injury, such as hemiparesis or hemianopsia, or other focal neurologic signs.

(c) Evidence of impairment of higher intellectual function w alterations of personality as a result of injury.

(d) Persistent focal w diffuse abnormalities of the electroencephalogram (EEG) reasonably assumed to be the direct result of injury.

(2) History of mild head injury (defined as loss of consciousness, amnesia, or the combination of the two for more than 5 minutes but less than 60 minutes), without linear skull fracture, is disqualifying for at least 6 months but may be acceptable if after that time neurological evaluation shows no residual dysfunction w complications.

(3) History of moderate head injury (defined as loss of consciousness, amnesia, or the combination of the two for more than 60 minutes but less than 24 hours), with no consideration fa waiver for at least 2 years after the injury.

(4) History of severe head injury (defined as loss of consciousness, amnesia, or the combination of the two exceeding 24 hours), with no consideration for waiver for at least 5 years after the injury.

(g) Hereditary disturbances. Personal or family history of hereditary or genetic disturbances, such as multiple neurofibromatosis, Huntington's chorea, hepatolenticular degeneration (Wilson's disease), acute intermittent porphyria, peroneal muscular atrophy, and familial periodic paralysis.

(h) Infectious diseases. Meningitis, encephalitis, or poliomyelitis within 1 year prior to examination, or it there are residual neurological defects that would interfere with satisfactory performance of military duty.

(i) Disorders of altered consciousness:

(1) Seizure/Epilepsy. Any paroxysmal convulsive disorder, including generalized seizure or partial seizure.

(2) Pseudoseizures or nonepileptic seizures.

(3) Syncope

(a) Any recurrent syncope.

(b) Syncope related to hypersensitive reflex.

(j) Spinal cord or column disorders resulting in motor, sensory, gait, or genitourinary dysfunction or chronic pain syndrome.

(k) Peripheral nerve disorder:

(1) Neuritis, neuropathy, or radiculopathy authenticated history of, whatever the etiology, unless:

(a) Limited to a single episode.

(b) The condition has completely subsided and the cause is determined to be of no future concern.

(c) The acute state subsided at least 1 year prior to the examination.

(d) There are no residuals that could be expected to interfere with normal function.

(2) Neuralgia (painful neuropathy) which is chronic, recurrent, or periodically incapacitating.

(3) Injury of one or more peripheral nerves, unless it is not expected to interfere with normal function.

(l) Myasthenia gravis or other neuromuscular junction disorder.

(m) Movement disorders Including; chorea, athetosis, torticollis, dystonia, or substantial tremor.

(n) Central nervous system shunts of all types.

(o) Evidence or history of involvement of the nervous system by toxic, metabolic, degenerative or nutritional disease process it there is any indication that such involvement is likely to interfere with normal function.