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Munchausen syndrome by proxy (MSP) is a recently described form of child abuse in which a caregiver fabricates or induces symptoms in a child in order to attract medical attention. The epidemiology, clinical features, diagnosis and the spectrum of MSP are reviewed. Central nervous system symptoms are a common presentation of MSP because they can be reported without confirmation. Three cases are reported to illustrate the most common neurological manifestations. It is important for neuroscience nurses to have an awareness that MSP can present as a neurologic problem, because appropriate management depends on early identification and treatment.