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March 09, 2023Special Article

Neurologic Care of Forcibly Displaced Persons: Emerging Issues in Neurology

View ORCID ProfileFarrah J. Mateen, View ORCID ProfileIbrahem Hanafi, View ORCID ProfileGretchen L. Birbeck, View ORCID ProfileAltaf Saadi, Erich Schmutzhard, View ORCID ProfileJo M Wilmshurst, MRCPaed FCPaed, Amy Bennett, View ORCID ProfileLyell K. Jones
First published March 1, 2023, DOI: https://doi.org/10.1212/WNL.0000000000206857
Farrah J. Mateen
1Department of Neurology, Massachusetts General Hospital, Boston
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Ibrahem Hanafi
2Department of Neurology, University Hospital of Würzburg, Germany
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Gretchen L. Birbeck
3Department of Neurology, University of Rochester Medical Center, NY
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Altaf Saadi
4Department of Neurology, Massachusetts General Hospital, Boston
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Erich Schmutzhard
5Department of Neurology, Medical University Innsbruck, Austria
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Jo M Wilmshurst
6Department of Paediatric Neurology, University of Cape Town, South Africa
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MRCPaed FCPaed
6Department of Paediatric Neurology, University of Cape Town, South Africa
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Amy Bennett
7American Academy of Neurology, Minneapolis, MN
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  • For correspondence: quality@aan.com
Lyell K. Jones
8Department of Neurology, Mayo Clinic, Rochester, MN
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Citation
Neurologic Care of Forcibly Displaced Persons: Emerging Issues in Neurology
Farrah J. Mateen, Ibrahem Hanafi, Gretchen L. Birbeck, Altaf Saadi, Erich Schmutzhard, Jo M Wilmshurst, MRCPaed FCPaed, Amy Bennett, Lyell K. Jones
Neurology Mar 2023, 10.1212/WNL.0000000000206857; DOI: 10.1212/WNL.0000000000206857

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Abstract

There is a growing number of forcibly displaced persons (FDPs) worldwide. With more than 100 million people forcibly displaced today, there is an urgent mandate to understand the neurologic care needs of this population and how neurologists and other health care workers can most effectively provide that care. In this Emerging Issues in Neurology article, we attempt to: (1) define the scope of the problem of providing neurologic care to FDPs, (2) highlight commonly encountered clinical challenges related to neurologic care of FDPs, and (3) provide useful clinical information for neurologists and other clinicians who deliver care to FDPs with neurologic needs. We address the terminology of forcible displacement and how terms may differ across a person’s migration journey.

Common challenges encountered by FDPs with neurologic needs across settings include loss of support systems, loss of personal health information, language barriers and differing expression of symptoms, differing belief systems, epidemiological patterns of disease unfamiliar to the clinician, and patients’ fear and perceived risks of engaging with health systems. Practical approaches are shared for clinicians who encounter an FDP with a neurologic presentation. Finally, the article discusses many unmet neurologic needs of FDPs, which require significant investment. These include addressing lapses in neurologic care during displacement and understanding the effects of forcible displacement on people with chronic neurologic conditions. Future research and educational resources should focus on improving epidemiological intelligence for neurologic conditions across geographies, developing curricula for optimizing the neurological care of FDPs, and evaluating the most appropriate and effective uses of health technologies in humanitarian settings.

  • Received September 21, 2022.
  • Accepted in final form December 7, 2022.
  • © 2023 American Academy of Neurology

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