Chapter 20 - Craniocerebral Conditions

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20.01 - Assessment of Neurological Disorders

In most neurological disorders, it is not feasible to produce a "table of disabilities" because of the marked variation between cases, and because the disability resulting from a neurological condition is, more often than not, a combination of deficits, e. g., visual field loss and clumsiness of one hand in multiple sclerosis, loss of speech and right hemiplegia in cerebral vascular disease, or behaviour disorder with muscular clumsiness following diffuse brain trauma.

Disability from neurological disease is dependent not so much on the cause as it is on the extent and location of the lesion( s) and the nature and severity of the resulting deficit.

20.02 - Assessment of Headache

"Headache", with no further clarification as to type, is a symptom only, almost universal in occurrence and not a disability; headache defined as 'muscle tension", "tension" or undefined, is assessed at nil.

In some cases, when headache actually interferes with ability to function, some minimal degree of disability is considered to exist, usually of the order of less than 5%. Exceptionally, the assessment would be 5% or more in cases of complicated migraine, i. e., where a permanent neurological deficit has occurred.

In dealing with headache and other episodic neurological disorders, such as epilepsy, one usually does not have a fixed deficit to assess; rather, the assessment is based on the overall impact which the disorder has on the individual's activities of daily living.

20.03 - Assessment of Disability Arising From Epilepsy

The criteria for evaluation of seizure disorders are based on the frequency, severity and duration of the attacks, the degree to which they are controlled, and the effect which they have on the pensioner's performance of the activities of daily living; such activities include getting dressed, bathing, preparation of meals, walking outdoors, operating a motor vehicle and, most importantly, ability to be left unattended.

Table to Article 20.03

Table to Article 20.03
  Frequency of Seizures 5 Years Drug Requirements Interference With Activities & Daily Living Requirement for Supervision
0-5% None Nil to minimal, single drug, no appreciable side-effects none None None
10-20% 1/ year or less Regular, may require multiple drugs, side effects may be present Slight None
25-40% 1/ year Regular, may require multiple drugs, side effects may be present Moderate Intermittent, for specific activities
50-70% 1/year but less than 1/month Use of multiple drugs with poor control Marked limitation Requires protected care
75-100% Seizures 1/month or greater Multiple drugs, little or no control Total Constant supervision

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