Document ID: chunk:federal_register_of_legislation:F2022L00003:reg:9:p1
Version: federal_register_of_legislation:F2022L00003
Segment Type: reg
Provision Reference: reg 9 (pt 1/2)
Character Range: 5052–8549

9               Factors that must exist
At least one of the following factors must exist before it can be said that, on the balance of probabilities, narcolepsy or death from narcolepsy is connected with the circumstances of a person's relevant service:
(1)          having concussion or moderate to severe traumatic brain injury within the 2 years before the clinical onset of narcolepsy, and in the case of sustained unconsciousness following injury to the head, the clinical onset of narcolepsy occurred within 2 years of regaining consciousness;
(2)          having a neurosurgical procedure involving the hypothalamus, midbrain or brainstem, within the 2 years before the clinical onset of narcolepsy;
(3)          undergoing a course of therapeutic radiation for cancer, where the brain was in the field of radiation, within the 3 years before the clinical onset of narcolepsy;
(4)          having a neurological disease, neurodegenerative disease or a paraneoplastic neurological syndrome, where the disease or syndrome involves the hypothalamus, midbrain or brainstem, within the 2 years before the clinical onset of narcolepsy;
            Note: Examples of neurological diseases, neurodegenerative diseases or paraneoplastic neurological syndromes that can involve the hypothalamus, midbrain or brainstem include:
               (i)              cerebrovascular accident;
               (ii)            disseminated encephalomyelitis;
               (iii)          hypoxic cerebral insult;
               (iv)           multiple sclerosis;
               (v)            neuromyelitis optica spectrum disorder; and
               (vi)           Parkinson's disease.
(5)          having:
(a)          a benign or malignant neoplasm; or
(b)          a non-malignant space occupying lesion;

involving the hypothalamus, midbrain or brainstem within the 2 years before the clinical onset of narcolepsy;
             Note 1: Examples of neoplasms that can involve the hypothalamus, midbrain or brainstem include lymphoma, glioma and craniopharyngioma.
             Note 2: Examples of non-malignant space occupying lesions that can involve the hypothalamus, midbrain or brainstem include neurosarcoidosis and vascular malformations.
(6)          receiving the adjuvanted influenza H1N1 vaccine PandemrixTM within the 2 years before the clinical onset of narcolepsy;
(7)          having infection of the pharynx with Streptococcus pyogenes within the 3 years before the clinical onset of narcolepsy;
(8)          having concussion or moderate to severe traumatic brain injury within the 2 years before the clinical worsening of narcolepsy, and in the case of sustained unconsciousness following injury to the head, the clinical worsening of narcolepsy occurred within 2 years of regaining consciousness;
(9)          having a neurosurgical procedure involving the hypothalamus, midbrain or brainstem, within the 2 years before the clinical worsening of narcolepsy;
(10)      undergoing a course of therapeutic radiation for cancer, where the brain was in the field of radiation, within the 3 years before the clinical worsening of narcolepsy;
(11)      having a neurological disease, neurodegenerative disease or a paraneoplastic neurological syndrome, where the disease or syndrome involves the hypothalamus, midbrain or brainstem, within the 2 years before the clinical worsening of narcolepsy;
            Note: Examples of neurological diseases, neurodegenerative diseases or paraneoplastic