Statement of Principles
concerning
GUILLAIN-BARRE SYNDROME
(Balance of Probabilities)
(No. 24 of 2018)
The Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(3) of the Veterans' Entitlements Act 1986.
Dated 2 March 2018
The Common Seal of the
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Professor Nicholas Saunders AO Chairperson
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Contents
2 Commencement
3 Authority
4 Revocation
5 Application
6 Definitions
7 Kind of injury, disease or death to which this Statement of Principles relates
8 Basis for determining the factors
9 Factors that must exist
10 Relationship to service
11 Factors referring to an injury or disease covered by another Statement of Principles
Schedule 1 - Dictionary
1 Definitions
1 Name
This is the Statement of Principles concerning Guillain-Barre syndrome (Balance of Probabilities) (No. 24 of 2018).
This instrument commences on 2 April 2018.
This instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986.
The Statement of Principles concerning Guillain-Barre syndrome No. 60 of 2013 made under subsection 196B(3) of the VEA is revoked.
This instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act 2004 applies.
The terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument.
7 Kind of injury, disease or death to which this Statement of Principles relates
Meaning of Guillain-Barre syndrome
(2) For the purposes of this Statement of Principles, Guillain-Barre syndrome:
(a) means an acute or subacute immune-mediated disorder of the peripheral nervous system producing symptoms and signs of impaired motor, sensory or autonomic functioning; and
(b) includes:
(i) acute inflammatory demyelinating polyneuropathy;
(ii) acute motor axonal neuropathy;
(iii) acute motor sensory axonal neuropathy;
(iv) Miller Fisher syndrome; and
(v) other variant forms of Guillain-Barre syndrome; and
(c) excludes chronic inflammatory demyelinating polyneuropathy.
Note 1: The most common variant of Guillain-Barre syndrome is acute inflammatory demyelinating polyneuropathy, which is characterised by rapidly progressive symmetrical limb weakness, loss of tendon reflexes, mild sensory signs and variable autonomic dysfunction.
Note 2: The diagnosis of Guillain-Barre syndrome is normally confirmed by electrodiagnostic testing or elevated protein concentration in cerebrospinal fluid without an elevated white cell count (cytoalbuminologic dissociation).
(3) While Guillain-Barre syndrome attracts ICD‑10‑AM code G61.0, in applying this Statement of Principles the meaning of Guillain-Barre syndrome is that given in subsection (2).
(4) For subsection (3), a reference to an ICD-10-AM code is a reference to the code assigned to a particular kind of injury or disease in The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM), Tenth Edition, effective date of 1 July 2017, copyrighted by the Independent Hospital Pricing Authority, ISBN 978-1-76007-296-4.
Death from Guillain-Barre syndrome
(5) For the purposes of this Statement of Principles, Guillain-Barre syndrome, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's Guillain-Barre syndrome.
Note: terminal event is defined in the Schedule 1 – Dictionary.
8 Basis for determining the factors
On the sound medical‑scientific evidence available, the Repatriation Medical Authority is of the view that it is more probable than not that Guillain-Barre syndrome and death from Guillain-Barre syndrome can be related to relevant service rendered by veterans or members of the Forces under the VEA, or members under the MRCA.
Note: MRCA, relevant service and VEA are defined in the Schedule 1 – Dictionary.
(1) having an infection with an organism from the specified list of infections, where that infection has been acquired within the two months before the clinical onset of Guillain-Barre syndrome;
Note: specified list of infections is defined in the Schedule 1 - Dictionary.
(2) being infected with human immunodeficiency virus at the time of the clinical onset of Guillain-Barre syndrome;
(3) having a clinically apparent herpes zoster infection in the two months before the clinical onset of Guillain-Barre syndrome;
(4) having a symptomatic gastrointestinal or respiratory tract infection in the two months before the clinical onset of Guillain-Barre syndrome;
(5) receiving an influenza vaccine or a nerve tissue derived rabies vaccine within the two months before the clinical onset of Guillain-Barre syndrome;
(6) having a malignant neoplasm, other than non-melanotic malignant neoplasm of the skin, at the time of the clinical onset of Guillain-Barre syndrome;
(7) having a solid organ or stem cell transplant before the clinical onset of Guillain-Barre syndrome;
(8) being treated with a tumour necrosis factor-α inhibitor in the two months before the clinical onset of Guillain-Barre syndrome;
(9) inability to obtain appropriate clinical management for Guillain-Barre syndrome.
(1) The existence in a person of any factor referred to in section 9, must be related to the relevant service rendered by the person.
(2) The factor set out in subsection 9(9) applies only to material contribution to, or aggravation of, Guillain-Barre syndrome where the person's Guillain-Barre syndrome was suffered or contracted before or during (but did not arise out of) the person's relevant service.
11 Factors referring to an injury or disease covered by another Statement of Principles
In this Statement of Principles:
(1) if a factor referred to in section 9 applies in relation to a person; and
(2) that factor refers to an injury or disease in respect of which a Statement of Principles has been determined under subsection 196B(3) of the VEA;
then the factors in that Statement of Principles apply in accordance with the terms of that Statement of Principles as in force from time to time.