Nueropsych evaluation

[jinga]

Originally Posted by Joy6

No I do not believe he is an experienced mTBI attorney...didn't realize I needed one until I realized one would be needed if you know what I mean. If this gets anymore difficult, I may need to get a more experienced lawyer with mTBI.

Joy,

I am in a similar boat - I want to return to my employer and did then I was removed until further notice - no exaxt explanation except I was told I could not have any restrictions of any kind ( I believe this to be discrimination and may look into that later) right now - I have no pay - and WC may take a a while.

I hope you have emerg funds to tap. I do have an atty who posed those ?? in last post to the other side and I will need to follow-up on the response. To be honest i am looking somewhat forward to being retested - to see where I stand literally\figuratively. I would love to have improved enought to return to pre- accident status but I know I still am having daily issues to deal with. Some days are better than others.

Keep in touch with me - seems like we are on similar paths with the ins companies on this

[Lightrail11]

Originally Posted by Joy6

Having one of these next week by order of workers comp. What should I expect? Should my husband accompany me?

Hi Joy. Since other have posted about the legal implications I won't comment further on that, but there are a couple reasons for your husband to accompany you. In addition to providing a ride and emotional support, the usual protocol is to include the spouse in the interview portion of the evaluation.

The evaluation itself will likely be performed by a PhD level clinical neuropsychologist. The typical format is an opening interview (which is where your husband would come in) followed by a series of tests which could include general intelligence tests (Wechsler AIS), a depression and/or anxiety inventory, verbal and visual recall such as digit span, trail marking, word memory, and pattern recall. Following the tests the neuropsychologist will probably review the finding with you.

[jinga]

Originally Posted by Lightrail11

Hi Joy. Since other have posted about the legal implications I won't comment further on that, but there are a couple reasons for your husband to accompany you. In addition to providing a ride and emotional support, the usual protocol is to include the spouse in the interview portion of the evaluation.

The evaluation itself will likely be performed by a PhD level clinical neuropsychologist. The typical format is an opening interview (which is where your husband would come in) followed by a series of tests which could include general intelligence tests (Wechsler AIS), a depression and/or anxiety inventory, verbal and visual recall such as digit span, trail marking, word memory, and pattern recall. Following the tests the neuropsychologist will probably review the finding with you.

Lighttrail,

How long was your testing? It sounds like it was a short session. The stesting i had was about 5 hours in total. Several different things.

[Lightrail11]

Originally Posted by jinga

Lighttrail,

How long was your testing? It sounds like it was a short session. The stesting i had was about 5 hours in total. Several different things.

About 4 hours: Initial inverview, subtests of WAIS-IV, Beck depression and anxiety inventory, Patient Competency Ratings Scale, WRAT-3, Rey Auditory Verbal Learning, Visiospatial memory test, trail marking A&B, WCST, Verbal Fluency, post testing evaluation and debrief.

[Mark in Idaho]

Unless the NeuroPsych office has specifically requested the spouse be present, they are not usually included. I have had three NPA's. Only one had my wife there and it was the 45 minute mini version done for SSDI by a generic psychologist. She was not asked about my cognitive and memory skills but rather behavioral issues.

The 4 and 5 hour NPA's were without my wife and did not include a debrief. The 5 hour was schedule to go into part of a second day but the NP stopped it early because he already had decided on a diagnosis.

IMO, A NeuroPsych who needs the spouse's comments is fishing for ways to deny the organic nature of the complaints.

Lightrail, I am curious about your Trailmaking test scores. What were your times and what was the evaluation of those times?

Often, the A and B times are not properly evaluated for concussion.

[Lightrail11]

Originally Posted by Mark in Idaho

Lightrail, I am curious about your Trailmaking test scores. What were your times and what was the evaluation of those times?

Hi Mark. The first time (still in hospital, 2 months post-accident):

"The patient completed part A in 34 seconds with 0 errors. The patient had significantly more difficulty in part B, eventually completed in 187 seconds with 1 error. Patient was proceeding slowly but once he made an error he had a difficult time finding his place and had to essentially go back to the beginning and work his way through in a much slower fashion.”

Evaluation (including the other tests): “Patient shows significant difficulties with visuospatial learning, recall, mental flexibility, abstract reasoning, and problem solving. Patient is not ready to return to work at this time. Patient should not drive given difficulties with mental flexibility/multitasking.”

The second evaluation 3 months later:

“The patient completed part A in 25 seconds with no errors; part B in 48 seconds with no errors (high average).

Evaluation: “Patient demonstrated intact cognition in all domains. He has shown an excellent recovery from his severe injury only five months ago. From a cognitive standpoint there are no concerns with the patient returning to work or driving”.

BTW in Essentials of Neuropsychological Assessment (2nd Ed, Hebben, Williams, 2009), for the interview portion of the evaluation currently the normal protocol is stated to include the spouse or close family member/caretaker.

[HeadStrong]

Had my Neuropsych yesterday. Was just over 5 hours and I was completely wiped out afterwards. Some was done on computer and some was done with manipulatives or out of booklets. My husband was included in initial interview.

I will say that I was under the impression that most of the interviews were conducted by Neuropsychologist and the exams were turned overr to "examiners".

This was not the case for me. The whole exam was given by the Chief of Clinical Neuropsychology for a very well known Dept. Of Neurology.

[Lightrail11]

Probably a relief to get that over with. Mine were conducted by the clinical neuropsychologist (PhD) as well. Did they review your results with you?

[HeadStrong]

No, I was told to call next week to schedule a time to review results. He said it would take a couple of days to write report and then send to Doc.

[jinga]

Hi,

I saw in your symptoms that you note a tigling sensation in extremities. Do you have a neck injury as well or are these symptoms part of the head injury? The reason I ask is that I have pain in arms\to fingers that has been associated with cervical disc bulges but since the accident I have waves of a icey\hote or tingling sensation that usually affect upper extremities and has an intermittent affect . I dont know exactly what brings it on but usually it seems in periods when I have a lot of things coming at me at once or feel overwhelmed.

Di your neuro test show any deficits in processing etc?

Jinga