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Forensic Neurology and the Role of Neurologists in Forensic Evaluations
William C Darby1, Ciaran M Considine1, R Ryan Darby2
1Dr. W.C. Darby is an Assistant Professor of Psychiatry, Department of Psychiatry and Biobehavioral Sciences, Division of Forensic Psychiatry, David Geffen School of Medicine at UCLA, Los Angeles, CA. Dr. Considine is an Associate Professor of Neurology, and Dr. R.R. Darby is an Assistant Professor of Neurology, Department of Neurology, Division of Behavioral Neurology, Vanderbilt University Medical Center, Nashville, TN.
Abstract:
Forensic psychiatrists may be asked to opine on neurological evidence or neurological diseases outside the scope of their expertise. This article discusses the value of involving experts trained in behavioral neurology in such cases. First, we describe the field of behavioral neurology and neuropsychiatry, the subspecialty available to both neurologists and psychiatrists focused on the behavioral, cognitive, and neuropsychiatric manifestations of neurological diseases. Next, we discuss the added value of behavioral neurologists in forensic cases, including assisting in the diagnostic evaluation for complex neuropsychiatric diseases, using expertise in localization to provide a strong scientific basis for linking neurodiagnostic testing to relevant neuropsychiatric symptoms, and assisting in relating these symptoms to the relevant legal question in cases where such symptoms may be less familiar to forensic psychiatrists, such as frontal lobe syndromes. We discuss approaches to integrating behavioral neurology with forensic psychiatry, highlighting the need for collaboration and mentorship between disciplines. Finally, we discuss several forensic cases highlighting the additional value of experts trained in behavioral neurology. We conclude that forensic psychiatrists should involve behavioral neurology experts when encountering neurological evidence that falls outside their scope of expertise, and the need for further cross-disciplinary collaboration and training.
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