Neuropsych Evaluation

[Nakamova]

Hey all --

Next Monday morning I'm going in for Neuropsych Evaluation. As I understand it, it's a bunch of tests to measure my cognitive functioning and set a baseline to measure any future mental decline. They should have done one 10 years ago when I was first diagnosed (and when my memory was sharper), but I guess better late than... uh, what was I saying?

Anyway, has anyone done one of these? It's going to run 3 hours, so I'd appreciate any tips on what to expect and how it's paced. Also, it's been a long time since I've had to take any sort of semi-academic test, so if someone could provide a cheatsheet that would be much appreciated

[Bernard]

I think they do these for everyone who is being evaluated for brain surgery.

[Rae1889]

Just remeber to spel your real name, not any screen names! lol

[Meetz1064]

help you with this one, Nak. I've never had one done. Good luck with it, though!! I'm sure you'll ace it!

[Cint]

Bernard is right, it is usually done before and after brain surgery. I had it done before my surgery, when my memory was much better. After surgery, memory was downhill.
Then I had it done again 10 years after surgery for evaluation for cognitive therapy because my memory is really bad now due to seizures, drugs, and surgery.
Basically they show you different pictures and have you tell them what you just saw. And it progressively becomes more difficult. They will read you lists of things and have you repeat as many as you can. And then come back later and see how many you can remember. This is where I failed. I could only remember 3. Oh, and I don't know if it's from the drugs, surgery or from having epilepsy, but I'm now somewhat dyslexia now, also and I have aphasia, too.

I hope you do much better.

[Nakamova]

Thanks all! Cindy, that info is very helpful. It sounds tough, so maybe I'll have an extra cup of tea before heading in Monday a.m. I'm not considering surgery in the least, so I think this is just my neurologist's way of being extra vigilant, and keeping the behavioral psych department busy on a slow day.

[matchu]

Hey all --

Next Monday morning I'm going in for Neuropsych Evaluation. As I understand it, it's a bunch of tests to measure my cognitive functioning and set a baseline to measure any future mental decline. They should have done one 10 years ago when I was first diagnosed (and when my memory was sharper), but I guess better late than... uh, what was I saying?

Anyway, has anyone done one of these? It's going to run 3 hours, so I'd appreciate any tips on what to expect and how it's paced. Also, it's been a long time since I've had to take any sort of semi-academic test, so if someone could provide a cheatsheet that would be much appreciated

I took this test, it was exhausting and a bit frustrating at times. I am not sure of the results tho.

[Nakamova]

I think I get a follow-up visit where they explain the results to me. And maybe also a separate visit with my neurologist, so she can give her take on the results.

[KelVarQ]

Hey Nak, I took this test prior and after surgery and I actually thought it was quite fun. It's not like the kind of tests we get in school, although most of them are timed but no worries. Just took it in May again (4+ yrs. after surgery - I waited) and in some areas I did better than I did after surgery (especially verbal memory) while some things I did better prior. All in all though I did better after surgery except visual memory, but I didn't do so great prior since that's where the abnormality was. Here's some examples:

1. They'll give you a picture with shapes and have you draw the picture (after they hide the picture). The 1st few are easy but they get harder. Although for me it did since that's visual memory and I didn't do so great prior and worse after, but that was to be expected).

2. They'll give you a list of words to remember and have you recall them later. Ex: Cow, shoe, dog, meatloaf, apple, cat, shirt, etc. (Tip: Try to organize the words into categories (foods, clothing, animals) when you hear the word since it's easier to recall later). This is the strategic part of the brain, which I did bad 1st time but much better after surgery. Later they may even ask you to list only the foods from the words given and by remembering them in categories helps. So try to organize them while your hearing them. They may do this test more than once with a whole new list of words (categories). So, organizing the words really does help.

3. They give you a letter and ask you tell them as many words as possible starting with that letter. Sounds easy? I thought so 1st time, but I found that I was all over the place and getting stumped left and right! (Tip: If they give you A start by thinking of words that start with Ab, then ac, ad, ae, af, ag, etc.) Again, stategic part of the brain and by trying to keep it in an organized way allows you to think of more words without totally racking your brain. Again, better after surgery.

4. They have you connect the dots. (Yes, just like when you were a kid!) They will use both letters and numbers so it goes like this...1, a, 2, b, 3, c, 4, d, etc.

5. Tell you a couple short stories and later ask you questions about it. (Verbal memory, did better after surgery).

6. Give you some rubik cube type thing and have you make shapes based on a picture shown.

7. Do some simple math problems in your head. (Bad prior and worse after...I can do math on paper but due to visual memory I can't hold (see) the numbers long enough in my mind to do the math).

8. Have you read a list of words (red, blue, green) where the color of the word could be red, blue or green. So when you read the list the word may be red but the color is blue and you have to say the word and not the color. They test the opposite as well...say the color and not the word.

9. Some simple questions, such as; who was the president during World War II. (Although I shouldn't say simple because I didn't do so great. Must have skipped those classes in school : )

10. Show you a bunch of pictures (faces) and then show them later to see if you remember seeing that picture along with similar ones. Visual memory : (

These are some examples and there's probably a few more similar ones. It's really not bad and again I found it fun since it's like elementary.


GOOD LUCK and you'll do fine! Try to get a good night sleep though the night before.

[matchu]

INDEED! and don't forget the doctor telling you to THINK! and getting frustrated because you don't remember that damn story word for word thirty minutes later! It is absolutely frustrating to me! there is actually a shape that you cannot make from the blocks and after I tell him I can't he then explains I am right. ERRR! Oh and the rules are the rules can change at any time.

[KelVarQ]

Hahaha, I found myself needing to tell them afterwards, "I really truly do have my Bachelor's Degree and I graduated high honors!"

[Cint]

1. They'll give you a picture with shapes and have you draw the picture (after they hide the picture). The 1st few are easy but they get harder. Although for me it did since that's visual memory and I didn't do so great prior and worse after, but that was to be expected).

2. They'll give you a list of words to remember and have you recall them later. Ex: Cow, shoe, dog, meatloaf, apple, cat, shirt, etc. (Tip: Try to organize the words into categories (foods, clothing, animals) when you hear the word since it's easier to recall later). This is the strategic part of the brain, which I did bad 1st time but much better after surgery. Later they may even ask you to list only the foods from the words given and by remembering them in categories helps. So try to organize them while your hearing them. They may do this test more than once with a whole new list of words (categories). So, organizing the words really does help.

3. They give you a letter and ask you tell them as many words as possible starting with that letter. Sounds easy? I thought so 1st time, but I found that I was all over the place and getting stumped left and right! (Tip: If they give you A start by thinking of words that start with Ab, then ac, ad, ae, af, ag, etc.) Again, stategic part of the brain and by trying to keep it in an organized way allows you to think of more words without totally racking your brain. Again, better after surgery.

4. They have you connect the dots. (Yes, just like when you were a kid!) They will use both letters and numbers so it goes like this...1, a, 2, b, 3, c, 4, d, etc.

5. Tell you a couple short stories and later ask you questions about it. (Verbal memory, did better after surgery).

6. Give you some rubik cube type thing and have you make shapes based on a picture shown.

7. Do some simple math problems in your head. (Bad prior and worse after...I can do math on paper but due to visual memory I can't hold (see) the numbers long enough in my mind to do the math).

8. Have you read a list of words (red, blue, green) where the color of the word could be red, blue or green. So when you read the list the word may be red but the color is blue and you have to say the word and not the color. They test the opposite as well...say the color and not the word.

9. Some simple questions, such as; who was the president during World War II. (Although I shouldn't say simple because I didn't do so great. Must have skipped those classes in school : )

10. Show you a bunch of pictures (faces) and then show them later to see if you remember seeing that picture along with similar ones. Visual memory : (

KelVarQ,

Was your surgery on the right or left? Mine was a LEFT temporal lobectomy and my verbal memory is what is really affected. When doing #2, I could only remember a few things after doing it over and over again. I was practically in tears. When we tried it later, I couldn't remember. My visual memory is good. I can remember faces, but not names. And for me like in example #5, if you ask for specifics in stories, if it isn't written down for me, I have trouble recalling details in stories. And I also difficulty with doing math problems in my head now. I have to see it on paper in order to figure it out. And #9 I could remember things such as those type things, before surgery. I didn't find it fun at all. It was humiliating for me! So it depends on where the seizures are coming from and where the damaged area is.

[KelVarQ]

That would make sense since I had RTL surgery and my visual memory was bad (before surgery bad, much worse after surgery) and verbal not so great, but better after surgery. I can remember names, but not faces. I can remember road signs, but not landmarks. Math...no go and only on paper. For me the verbal is on my left side and visual on the right and it sounds the same for you. I'm also left handed and they had to do a few more tests prior to surgery to ensure my speech would not be impacted and they said if I were right handed I wouldn't have needed so many tests.

Here's something a doctor told me as to why my verbal and ability to focus improved GREATLY after surgery. Think of a T.V. (static - snow) that's the seizure brain and once you remove the abnormality the rest of the brain can function properly. So, my verbal wasn't great prior to surgery due to the (static - snow, hence not an abnormality) and once the abnormality was removed (RTL visual memory) the static went away and everything else improved except for the area they removed. So, basically sacrificed the visual memory (wasn't working properly anyway) and now the rest of my brain can function properly. However, talk to me in a year or so and I may be singing a different tune since I now have seizures again. Diagnosed again in May 09, although started having them about a year prior but denial can be powerful.

[RobinN]

It was suggested for Rebecca when she was going through some of the worst side effects while on meds. I objected and also objected to school testing for the same reasons. It would not be testing her under normal conditions. She was not herself and I did not want something in her file that was drug induced. I did not want that as a baseline. This has never been suggested again, since she is off of meds and side effects are nonexistent.

I was also told by Rebecca's therapist that there are adequate tests and then more thorough tests. There was quite a difference in $$ and she knew that insurance would only cover the most basic of tests.

[Nakamova]

I agree, it would have been much better to be able to take this test unmedicated, before the experiences of Dilantin, Zonegran, Lamictal and all my tonic-clonics. But since I'm always hopeful of going off meds, the testing might be useful to show how much I improve if that ever happens -- or how much worse I get otherwise. It was my neurologist's idea to do the test, and I would never have agreed unless it was covered by my insurance. I still feel a tad ambivalent about it because my insurance doesn't categorize it under neurological testing, but under behavioral therapy(!)

[matchu]

I agree, it would have been much better to be able to take this test unmedicated, before the experiences of Dilantin, Zonegran, Lamictal and all my tonic-clonics. But since I'm always hopeful of going off meds, the testing might be useful to show how much I improve if that ever happens -- or how much worse I get otherwise. It was my neurologist's idea to do the test, and I would never have agreed unless it was covered by my insurance. I still feel a tad ambivalent about it because my insurance doesn't categorize it under neurological testing, but under behavioral therapy(!)

In my case covered test.. ended up not being covered after all and I have to pay the fee.

[KelVarQ]

Yes, the test is expensive and I had to pay out of pocket close to a $1,000, but I was lucky because my insurance company covered the majority of it.

Robin, I understand your concerns with testing and I too feel that standardized testing (school) is absolutely wrong for more reasons than one, whether drug induced or not. However, the neuropsych test I found very helpful and I'm glad that I took it (well in my case I had to) because it allowed me to work on areas that were weak, such as; the strategic part of my brain. (I mentioned some tips in the list I put up and that was from learning how to exercise that area and ultimately I did better the 2nd time. Obviously the surgery helped, but I also learned different strategies to help areas along that I found out were weak).

Actually I would recommend even those without E to take that test because they test so many areas of the brain that you get a sneak peak as to your strengths and weaknesses, which ultimately allows you to work on and strengthen those weaknesses since our brain is a muscle and as we all know...has memory, which all muscles do.

[Nakamova]

Well I had my test this morning. It was not bad at all. It was very much as you described it Kel. I really appreciate having that information going in. Although I was disappointed that they didn't ask me who the president was during WWII -- I was all prepared for that one! The set of face pictures they showed me were all black-and-white headshots of guys from the 1960s -- it was hard not to laugh at the sideburns and ugly ties...

I think math problems and pattern recognition will turn out to be my weakest areas, but I'll meet with the examiner in two weeks to get the full report.

[RanMan]

Hi Nak,
Here's my experience of that test from a different perspective and how it can be used against you.

I had that neurologist/phych test back in 2004..........REQUESTED BY MY THEN EMPLOYER OF 30 YEARS. The purpose was to document what I can and can't do (they thought I was faking it to get out of doing certain things.)

I was an administration manager for the Gov't of Canada and as a result of the side effects from my anti-epileptic drugs, I couldn't make the quick judgements and decisions like I used to and I guess it was effecting my job performance (I didn't see it but they had to trim staff and I was close to retirement)

They told me that the results of the test showed that as a result of long term use of anti-epileptic drugs,I no longer had the capability to learn a new job so my employer recommended that I go on early retirement (for medical purposes) and I was given a financial package and "put out to pasture".

I argued with them that this was a violation of my Human Rights but since it was documented, I was "SCREWED".
I had the same test as described above and the results were documented and put on my employment file.

Randy

[s10sleeper]

I have had this test about 4 times over the past year, twice before my RNS implant, one time was to see if I was eligible for brain surgery. Then 2 times, once every 3 months after the RNS implant. As long as a person is patient it isn't bad, especially if you like doing puzzles. Although they say it can take about 3 hours, I have never gone over and hour and a half on it.