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SOP BULLETIN

# 28

4 November 1999

THE FOLLOWING SOPS ARE TO BE GAZETTED ON 10 NOVEMBER 1999

New SOPs

Cluster headache

Secondary Parkinsonism

Malignant neoplasm of the eye

Revocations & Replacements

Migraine

Tension-type headache (replaces tension headache)

Parkinson's disease (replaces Parkinson's disease and Parkinson's syndrome)

Myeloma (replaces multiple myeloma)

Polycythaemia vera

Diabetes mellitus

Non-Hodgkin's lymphoma

Amendments

Nil

IMPORTANT OPERATIONAL FEATURES

Cluster headache syndrome

New – 66 & 67 of 1999

Migraine

Revocation - 74 & 75 of 1999
(replaces 3 & 4 of 1996)

Tension-type headache

Revocation - 76 & 77 of 1999
(replaces 259 & 260 of 1995)

These SOPs have resulted from a formal investigation into whether head or neck trauma is causal for headaches.

The RMA has decided that head or neck trauma is not a cause of migraine or tension-type headache.   Cluster headache syndrome does include a head trauma factor.  For SOP purposes “post-traumatic headache” is not a separate entity.  Claims for “post-traumatic headache” should be determined under one of the above three SOPs, depending on the clinical presentation.  The exception is if the headaches are due to a demonstrable structural abnormality (eg. subdural haematoma), in which case that abnormality should be diagnosed.   The diagnostic protocols will provide full details.

Note that for tension-type headache to be diagnosed there must be at least 5 headaches/month on average.  Headaches occurring at a lower frequency should be regarded as not a disease (N.I.F.).

Parkinson's disease

Revocation – 68 & 69 of 1999
(replaces 122 & 123 of 1996)

Secondary Parkinsonism

New - 70 &n 71 of 1999

These SOPs have resulted from a formal investigation into whether carbon tetrachloride or head trauma is causal (outcome - no).

The previous Parkinson's disease and Parkinson's syndrome SOP has been split in two.  The Parkinson's syndrome part is now called secondary Parkinsonism.

In the Secondary Parkinsonism SOP there is a new factor for encephalitis and some of the time periods in the factors have been standardised.

New diagnostic protocols (DPs) advising what to do if you cannot establish whether the diagnosis is Parkinson's disease or secondary Parkinsonism, should be available on CCPS Research (hopefully) about a week after SOP gazettal.  In the mean time the gist of the existing DP should be followed.

Malignant neoplasm of the eye

New – 64 & 65 of 1999

The definition in this SOP contains a range of exclusions, requiring care with the diagnosis to ensure that the SOP applies.

Myeloma

Revocation – 72 & 73 of 1999
(replaces 122 & 123 of 1996

This SOP has been revised following a formal investigation into whether benzene is causal (it was found not to be).

The SOP has been extended to cover plasma cell leukaemia and solitary plasmacytoma and has hence been renamed (previously multiple myeloma).

The herbicide/Vietnam factors have been updated as per other recent SOPs with these factors.

Polycythaemia vera

Revocation – 74 & 75 of 1999
(replaces 67 & 68 of 1995)

This SOP has been revised following a formal investigation into whether ionising radiation is causal (the requesting veteran's case received some media attention, including on 60 Minutes).

The SOP contains a new definition.

The only factor remains inability to obtain appropriate clinical management.

Non-Hodgkin's lymphoma

Revocation – 80 & 81 of 1999
(replaces 67 & 68 of 1995)

Diabetes mellitus

Revocation – 82 & 83 of 1999
(replaces 67 & 68 of 1995)

These SOPs have been revised to correct minor typographical errors.

The opportunity has also been taken to make the change to ICD-10-AM codes.

Remember! If you are having any problems with SOPs, or SOPs in CCPS, talk to us!