Moreno A, Grodin M A
Boston University School of Public Health, 715 Albany Street, MA 02118-2526, USA.
Spinal Cord. 2002 May;40(5):213-23. doi: 10.1038/sj.sc.3101284.
Refugees and asylum seekers continue to enter the United States and the European Union in record numbers. Some have estimated that between 5-35% of all refugees have suffered torture in their countries of origin. Although general practitioners and specialized physicians are likely to encounter victims of torture as patients, few providers are familiar with the health problems that may affect this patient population.
:To provide neurologists, neurosurgeons, and rehabilitation medicine physicians with basic knowledge about survivors of torture that can help in the diagnosis, treatment, and referral of such patients.
A MEDLINE (1966-October 2001) search using keywords torture and sequelae (nervous system diseases and brain injuries) was conducted. Other data sources included books, reference lists, online resources and expert opinion.
:Forms of torture that may affect the nervous system include beatings, gunshot wounds, stab wounds, asphyxiation, prolonged suspension and electrocution. Victims of torture commonly experience neurological symptoms such as headaches, vertigo, loss of consciousness and dizziness during and after torture. A successful and meaningful clinical interaction with a survivor of torture includes avoiding retraumatization, building trust, spelling out any limits on confidentiality, and above anything else, establishing empathy with the patient.
Neurological sequelae of torture can be devastating physically and psychologically. The treatment of these neurological conditions does not differ from other patient populations. However, the clinical approach is unique and must focus on avoiding retraumatization and helping the victim reintegrate into society as quickly as possible.
难民和寻求庇护者继续以创纪录的数量进入美国和欧盟。有人估计，所有难民中有5%至35%在原籍国遭受过酷刑。尽管全科医生和专科医生可能会遇到遭受酷刑的受害者前来就医，但很少有医疗服务提供者熟悉可能影响这一患者群体的健康问题。
为神经科医生、神经外科医生和康复医学医生提供有关酷刑幸存者的基本知识，以帮助对此类患者进行诊断、治疗和转诊。
利用关键词“酷刑”和“后遗症（神经系统疾病和脑损伤）”对MEDLINE（1966年至2001年10月）进行检索。其他数据来源包括书籍、参考文献列表、在线资源和专家意见。
可能影响神经系统的酷刑形式包括殴打、枪伤、刺伤、窒息、长时间悬吊和电击。酷刑受害者在遭受酷刑期间及之后通常会出现头痛、眩晕、意识丧失和头晕等神经症状。与酷刑幸存者进行成功且有意义的临床互动包括避免再次造成创伤、建立信任、明确任何保密限制，以及最重要的是，与患者建立同理心。
酷刑造成的神经后遗症在身体和心理上可能具有毁灭性。这些神经疾病的治疗与其他患者群体并无不同。然而，临床方法是独特的，必须侧重于避免再次造成创伤，并帮助受害者尽快重新融入社会。
