Current RMA Instruments

Changes from previous Instruments

SOP Bulletin 218

ICD Coding

• ICD-9-CM Codes: 294.1
• ICD-10-AM Codes: F02.8

Brief description

Dementia pugilistica is the name given to the chronic neurological (cognitive, motor and behavioural) impairment that occurs as a sequelae of professional boxing (in around 20% of such boxers).  The RMA has not determined a SOP, nor decided not to make a SOP, for the (still controversial and yet to be established) entity that is referred to as chronic traumatic encephalopathy and attributed to e.g. multiple concussive episodes.  This SOP is not intended to cover such claims.

Confirming the diagnosis 

Diagnosis is made from a combination of history, neurological/cognitive assessment (which may include neuropsychological testing and brain imaging.

The relevant medical specialist is a neurologist.

Additional diagnoses covered by SOP

• "slap-happy syndrome"
• "punch drunk syndrome"
• chronic progressive traumatic encephalopathy of boxers

Conditions not covered by SOP

• Any type of dementia other than dementia pugilistica
• Parkinson disease and secondary parkinsonism*

* another SOP applies

Clinical onset

Once the diagnosis has been established/confirmed (with a sufficient level of neurological decline) it may be possible to back-date onset to an extent, based on symptoms/signs, but it may be difficult to establish a point at which the decline in function reached a level sufficient to warrant diagnosis.