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Old 01-09-2014, 02:38 PM
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neuropsychology


Who here has seen a neuropsychologist for their epilepsy? It's been recommended to me by a few people, not my epileptologist. I'm just wondering why it's been suggested. I don't know the difference between a psych and neuropsych, I've never seen either. I'm not seeing my epileptologist until March.
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Lauren, twenty-something years old in Utah. I'm in year sixteen of an epilepsy diagnosis and still awaiting seizure control. I currently work as the editor for the Epilepsy Association of Utah and I had a baby boy in January 2013.


SEIZING THE DAY SINCE 1997!
Take Lamictal: it's not called ePILLepsy for nothing!
Take it with Trileptal: monotherapy is for wusses!
Proud co-captain of the Battlestar Epileptica!

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Old 01-09-2014, 02:52 PM
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Some work closely with Epileptologists and in Seizure Investigation Units since many people - I was told as high as 30% - of those with normal EEGs and who seemingly have intractable epilepsy have psychogenic seizures or episodes that look like seizures but that are caused by other medical conditions (eg. dystonia, periodic limb movement disorder, parasomnias, etc.). The psychiatrist/neuropsychiatrist role in cases like this is to assist the Epileptologist in determining if seizures may be psychogenic. Seeing the neuropsych. is routinely part of admission to the SIU in my area when seizures do not show up on an EEG.

I know these professionals have other roles as well, such as helping people cope with epilepsy and performing pre-surgical testing.

Last edited by masterjen; 01-09-2014 at 02:54 PM.
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Old 01-09-2014, 04:40 PM
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hey jen sounds like lauren is referring to neuropsychologist rather than neuropsychiatrist. is quite a difference in these professions, i know first hand from being in the unit 17 days. tho they both work closely re: seizure disorders and the unit it's mostly for different reasons. my 'ologist' was the first specialist (wow could she ask one more damn question?! exhausting), so that she could determine mental state, triggers, weaknesses, etc.
the 'iatrist' was close to the end, as i had many seizures and it was determined i was likely a good candidate. she came to my room, just her and i, to comfort me with any questions i may have re: opting for brain surgery and what my type of seizures had really been doing to my head. gave me articles and showed me deep pics of the brain online and what was actually happening. major reality, came to a point i couldn't talk i was crying so hard. but she knew how to handle that and be supportive, and answered ANYTHING i wanted to know about what our brains go through mentally and what was about to happen.
their roles seemed quite different, as in one digs for unknown answers and the other helps confirm and explain the answers.
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Old 01-09-2014, 05:28 PM
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Hi, qtowngirl - now I'm not sure who asked me a million and one questions anymore, an 'ologist or 'iatrist So the 'ologist would be the one who would do cognitive-type testing, and the other to ask about your childhood etc. (lol)?
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Old 01-09-2014, 05:56 PM
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yep ologists ask a million questions (seen her back to back with a full day of neurotesting. and it was my damn birthday!), and the iatrist was an explainer as well as an open ear. this is where i broke down and told her about my first seizure, a simple partial at 15. being the first it dug deep and pulled out my most horrid memory (which was blanked out of me for 9 years) from age six on. was a sexual assault from a male babysitter (parent's best friend's teenage son) when he put me to bed.
so, the memory of that night and my first seizure all at once, is basis why all of my s.p.'s have been fear based. i couldn't stop the tears with her so just opened up completely. very exhausting meeting, but worth it. she knew ALOT about stress, fear, pain, anguish and all other emotions and triggers.
tho very trained in e, an ologist is in a different area of that type of emotional field for sure.
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Old 01-09-2014, 09:02 PM
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I've seen a neuropsychiatrist. It was primarily for cognitive testing rather than for an exploration of emotional factors in epilepsy. She ran me through a bunch of memory and cognitive tests, and then I saw her for a second time to go over the results. The idea was to get a baseline for how well my brain was behaving, and to flag any weak areas. I can use the test results to evaluate and future cognitive changes I may have (whether from seizures, meds or other causes).
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Old 01-09-2014, 10:40 PM
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So Nakamova, would I be correct in assuming that your experience is a standard one from a neuropsychiatrist? I ask because I feel none of my current doctors are paying enough attention to my cognitive problems, which are destroying my life, and I really need someone to pay attention and take some action.
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Old 01-10-2014, 12:30 AM
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Before my brain surgery, I saw a neuropsychologist who put me thru a multitude of tests to pinpoint the area of my speech and memory. I also saw one six months after the surgery to test my memory again. The surgery had impaired my cognitive abilities some according to the tests. I also saw a neuropsychologist several years ago for some more memory/cognitive therapy.

Quote :
http://www.epilepsy.com/epilepsy/spe...opsychologists

A neuropsychologist is a "Ph.D." or a "Psy.D." who has gone through general training in psychology as well as specific training in neuropsychology. Neuropsychologists usually work in hospitals, in centers that focus on one disorder, or in their own private practice. They may evaluate how your brain is working, perform research to understand the brain better, or treat people whose nervous system has been injured by a disease, disorder, or accident. Neuropsychologists are interested in how seizures affect the way a person with epilepsy thinks and remembers. They are involved in neuropsychological testing and special procedures like brain mapping or the Wada test (also known as the intracarotid sodium amobarbital procedure).
I also started seeing a neuropsychiatrist six months after the surgery because I started slipping into a depression. The neuropsychiatrist specialized in epilepsy and it's emotional, behavioral effects, so knew how to treat it. He treated me with a tricyclic anti-depressant and finally added an SSRI anti-depressant after trying many, many medications because nothing was working to ease the depression. I was even suicidal at the time. So, IMO, neuropsycholgists are the ones who usually administer the language, memory, attention tests. Neuropsychiatrists treat the anxiety, depression problems
that go along with epilepsy for some, especially those with temporal lobe epilepsy.
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Last edited by Cint; 01-10-2014 at 12:39 AM. Reason: added words
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Old 01-10-2014, 09:31 AM
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Originally Posted by Cint View Post:
So, IMO, neuropsycholgists are the ones who usually administer the language, memory, attention tests. Neuropsychiatrists treat the anxiety, depression problems that go along with epilepsy for some, especially those with temporal lobe epilepsy.
in the unit was exactly as such.
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Old 01-10-2014, 09:13 PM
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I had some cognitive testing when I was first diagnosed withe epilepsy as a child. I remember some of the tests/games, and that I had a college level vocabulary.

In 2006 I saw a neuropsychologist in Boston. She was awesome. With her and a graduate assistant I took two days of testing (probably less than 6 or 8 hours total). It was a bunch of tests or mind games. It wore me out a bit, but I thought it was fun. Mostly I liked the idea that someone might for once acknowledge that there might be something wrong with my memory and cognition. She met with me twice to discuss the results. The "good" parts were that I had a problems with working memory (like doing math problems in your head), I was very slow even with things I was good at, and I was terrible at math compared to other things. She said that I did not have memory problems, which I disagreed with strongly. The difference seemed to be that in her opinion I had problems "encoding" information rather than "remembering" or recalling it. That may or may not be right, but it seems to me that if you can't remember something you have a problem with "memory". The "bad" part was that she told me I am very smart (according to what measure I don't know), but that made me feel bad because I felt like I had little to show for it. We also discussed some of the results from the standardized testing I had taken (ACT, SAT, GRE), as well as my college transcripts.

For the most part we stuck with the results of the tests she did, but she took quite a while with me. One thing I remember that was very helpful was that she said she was impressed that I had persevered with my education in spite of my difficulties (7 1/2 years of college at that point - I was in grad school). I had always been so frustrated because I felt that I was smart enough, but just couldn't get the sort of grades I wanted or needed. I studied for some stuff more that necessary and got "C"s, then did the minimum on other things and got "A"s. Overall my GPA was mediocre to ok, or even good, but not good enough. So, I felt for a long time like I was little better than a failure. Since high school, academically I had often felt like something of a delinquent. She was the first person to see that I tried hard (and I did), and to acknowledge that I had some significant challenges that others at my level did not.

She also suggested that I see a psychiatrist in the neurology department to discuss minor depression issues. I saw him once. He prescribed me some anti-depressants, but I didn't fill the prescription. At the time I couldn't see what the good of taking another pill would do, especially if my meds were the worst of the problem (as I thought). Perhaps I should have tried it, but at least I got to talk to someone about it and have the opportunity.

I saw the neuropsychologist again a couple years later. She did some of the tests again. I did a little worse on some of them (I was on a lot more medication), but for the most part was the same. I felt better that I had some proof (at least in my mind) that the new meds were causing cognitive issues.

Overall, it was not life changing. She did make some suggestion as far as academic "accommodations", which never came to much and I didn't like using them. I had already figured out most of the life strategies I discussed later with one of her graduate assistants. It did change my perspective on my pursuits. Academically I decided that I was just not going to waste time on things that I knew from long experience, and from the test results I wasn't good at. A sincere try is one thing, banging your head against the wall is another. I decided to focus more on my strengths. I had spent way too much time on my weaknesses up until that point.

For the most part I was very glad for the experience because it did give me some objective measure of what was wrong with me cognitively, and it was about the only time anyone ever acknowledged my deficits, rather than telling me I was imagining things or was just lazy or something. It was a positive experience.
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Old 01-10-2014, 11:07 PM
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Thanks for all the responses everyone, you've been a great help.
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Lauren, twenty-something years old in Utah. I'm in year sixteen of an epilepsy diagnosis and still awaiting seizure control. I currently work as the editor for the Epilepsy Association of Utah and I had a baby boy in January 2013.


SEIZING THE DAY SINCE 1997!
Take Lamictal: it's not called ePILLepsy for nothing!
Take it with Trileptal: monotherapy is for wusses!
Proud co-captain of the Battlestar Epileptica!

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