Loss of consciousness (non-traumatic)

Considerations

Any history of loss of consciousness (LOC) needs to be thoroughly investigated. It is useful and often essential to question witnesses to the episode. Review of any clinical notes and investigations are similarly important. Careful history taking about any previous episodes is important.

Unless the cause is clear it is usually necessary to investigate potential cardiac and neurological causes for loss of consciousness, including epilepsy. Most cases seen by the CAA are vasovagal in aetiology and are discussed in more depth in the cardiology chapter.

An ME should not accept at face value a reported history of normal investigations. These must be obtained for perusal.

Information to be provided

• Copy of all medical records pertaining to the LOC;
• Copy of GP notes;
• Copy of the original reports of any investigations;
• Copy of all specialists’ reports.

Disposition

An applicant with a history of LOC should be considered as having a condition that is of aeromedical significance unless:

• The LOC was a single episode of clearly provoked vasovagal syncope, occurring at least five years prior; or
• A previous AMC has considered the case in detail and concluded favourably, allowing a return to flying, perhaps with restrictions; and
• There has been no new episode.

Note: The word 'provoked' refers to typical conditions such as medical procedures, etc. A LOC provoked by conditions that may be met in flight is of concern.