Neurologic evaluation of violent juveniles.
Any juvenile who has acted violently requires a systematic, meticulous neurologic evaluation. There is no substitute for an adequate medical, family, and social history, the latter focusing on abuse and neglect. Evaluation should include a full physical and a conventional neurologic examination. Additionally, the physical, neurologic examination must include tests of cerebral-cortical function. The history and physical examination usually will indicate the diagnosis. A neuropsychologic evaluation of higher cerebral functions, including tests of frontal functions, should also be done in most cases. Some specific causes of brain disease can be identified by appropriate blood and urine tests, waking and sleep EEGs, and neuroimaging investigations. In general, positive findings are more significant than negative findings. If the physical examination and psychological tests are negative and the MR imaging shows a brain tumor, the patient has a brain tumor. If the neurologic or neuropsychological examinations demonstrate brain dysfunction, the patient has brain dysfunction, even if MR imaging is normal.
Pincus
J H
JH
Department of Neurology, Georgetown University, Washington, DC, USA.
D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D001921:Brain / Q000098:blood supply / Q000503:physiopathology*; D002560:Cerebrovascular Circulation / Q000502:physiology; D004569:Electroencephalography; D005625:Frontal Lobe / Q000098:blood supply / Q000503:physiopathology; D006801:Humans; D007604:Juvenile Delinquency / Q000523:psychology*; D008279:Magnetic Resonance Imaging; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D012920:Social Behavior Disorders / Q000503:physiopathology*; D014055:Tomography, Emission-Computed; D015899:Tomography, Emission-Computed, Single-Photon; D014754:Violence / Q000523:psychology*