title: Neurological Manifestations of Medical Child Abuse.
abstract: BACKGROUND
  Medical child abuse occurs when a child receives unnecessary and harmful, or potentially harmful, medical care at the instigation of a caretaker through exaggeration, falsification, or induction of symptoms of illness in a child. Neurological manifestations are common with this type of maltreatment.
  
  
  OBJECTIVE
  We sought to review common reported neurological manifestations that may alert the clinician to consider medical child abuse. In addition, the possible sequelae of this form of child maltreatment is discussed, as well as practice recommendations for establishing the diagnosis and stopping the abuse once it is identified.
  
  
  METHODS
  A review of the medical literature was conducted regarding the reported neurological presentations of this entity.
  
  
  RESULTS
  Neurological manifestations of medical child abuse include false reports of apparent life-threatening events and seizures and reports of induction of symptoms from poisoning. Failure to correlate objective findings with subjective complaints may lead to unnecessary and potentially harmful testing or treatment. This form of child maltreatment puts a child at significant risk of long-term morbidity and mortality.
  
  
  CONCLUSIONS
  A wide variety of neurological manifestations have been reported in cases of medical child abuse. It is important for the practicing neurologist to include medical child abuse on the differential diagnosis.
authors.affiliation: Division of Child and Family Advocacy, Department of Pediatrics, The Center for Family Safety and Healing, Nationwide Children's Hospital, Columbus, Ohio.
authors.forename: Katharine
authors.initials: K
authors.lastname: Doughty
authors.affiliation: Division of Child and Family Advocacy, Department of Pediatrics, The Center for Family Safety and Healing, Nationwide Children's Hospital, Columbus, Ohio.
authors.forename: Corey
authors.initials: C
authors.lastname: Rood
authors.affiliation: Division of Pediatric Neurology, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio; The Ohio State University College of Medicine, Columbus, Ohio.
authors.forename: Anup
authors.initials: A
authors.lastname: Patel
authors.affiliation: Division of Child and Family Advocacy, Department of Pediatrics, The Center for Family Safety and Healing, Nationwide Children's Hospital, Columbus, Ohio; The Ohio State University College of Medicine, Columbus, Ohio.
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Thackeray
authors.affiliation: Division of Child and Family Advocacy, Department of Pediatrics, The Center for Family Safety and Healing, Nationwide Children's Hospital, Columbus, Ohio; The Ohio State University College of Medicine, Columbus, Ohio. Electronic address: Farah.Brink@nationwidechildrens.org.
authors.forename: Farah W
authors.initials: FW
authors.lastname: Brink
mesh_terms: D002648:Child; D002649:Child Abuse / Q000175:diagnosis / Q000517:prevention & control; D006801:Humans; D020258:Neurotoxicity Syndromes / Q000175:diagnosis / Q000503:physiopathology* / Q000517:prevention & control; D063487:Prescription Drug Misuse / Q000517:prevention & control
keywords: Munchausen syndrome by proxy; child abuse; covert video surveillance; medical child abuse; multidisciplinary child protection team