Neurologists ask about which diseases and medical conditions have affected your biological relatives because family health history is a risk factor for some neurologic conditions, such as certain types of epilepsy and movement disorders. Sharing your family history could help your neurologist diagnose you more accurately and uncover information that might otherwise be overlooked. For example, most kinds of headaches don't run in families, but there are rare hereditary types of migraine.
If your family's medical history includes certain neurologic conditions, such as Huntington's disease or frontotemporal dementia, the neurologist may discuss genetic testing—which would show whether you (or relatives) might be at risk for them. The child of a parent with Huntington's disease—an inherited neurologic illness that causes involuntary movements and severe emotional and cognitive decline and is fatal—has a 50 percent chance of inheriting the gene that causes the disorder.
Understanding your family's history, along with genetic testing and consultation with a neurologist and a genetic counselor, can help you determine the risks that can be passed on to children and whether you want to be involved in medical research related to potential prevention and treatments.
It's important to remember that with certain disorders, including Alzheimer's disease and stroke, even if you have a family history you can manage or lower modifiable risk factors such as high blood pressure, obesity, and diabetes. That's another reason to tell your doctor whether any relatives have those conditions.
If you have not compiled your family medical history, now is a good time to do so. The US Centers for Disease Control and Prevention (CDC) provide guidelines on what questions to ask and which relatives to approach for the family record. The history should include the health status of your biological parents, grandparents, siblings, half-siblings, children, aunts, uncles, nieces, nephews, and cousins. The CDC recommends using family gatherings as an opportunity to broach this topic.
A family health history should include major medical conditions, causes of death, age at diagnosis, age at death, and racial/ethnic background. Update the information regularly and share what you've learned with your doctor. Online tools from the Department of Health and Human Services and the National Human Genome Research Institute can help you keep track of the material.
A document is useful, but in many cases your neurologist will ask questions and focus on what's most relevant about your family's health history.
Dr. Pressman is assistant professor of cognitive and behavioral neurology at the University of Colorado in Aurora, where he practices medicine and is involved with observational research and clinical trials at the university’s Alzheimer’s and Cognition Center.
