Neurologists should ask patients about abuse

A new position statement issued by the American Academy of Neurology calls on neurologists to begin screening their patients for abusive or violent treatment by family, caretakers or others. The position statement is published in the January 25, 2012, online issue of Neurology.. Types of abuse include elder abuse, child abuse, sexual abuse, financial abuse, emotional abuse, bullying, cyberbullying and violence.

"Neurologists see patients with neurologic disorders that may make them more susceptible to abuse or neglect," said lead author Elliott A. Schulman, MD, of Lankenau Medical Center in Wynnewood, Penn., and a Fellow of the American Academy of Neurology. "They also see patients with neurologic issues that may be either directly or indirectly related to mistreatment."

More than 90 percent of all injuries from intimate partner violence occur to the head, face or neck region, and can lead to traumatic brain injury, according to the position statement. People with neurologic disorders such as Parkinson's disease, Alzheimer's disease or stroke may be at higher risk for abuse and neglect.

"By routinely asking about violence and abuse, the neurologist increases the opportunity for both identifying ongoing abuse and intervening when appropriate," Schulman said. "In addition to further physical and emotional harm, consequences of not asking about abuse might include failure of treatments and, when children are exposed to abuse, perpetuation of the cycle of abuse from generation to generation."

The position statement outlines 10 principles of intervention by the neurologist when meeting with patients, beginning with integrating questions about abuse into the medical history and routinely screening all patients for past and ongoing violence.

The Academy is also offering free training to members interested in seeking to help address domestic violence issues in their communities.