Neuro - pyschological assessment. What to expect?

[twist330]

I have this on Monday as my Neuro has run out off idea and thinks my problems may be "functional" and I may have a "chemical imbalance". I really can't find any relevant information on the web. While I am happy to talk to someone I have found suggestions of written examinations (scares the hell out of me) and IQ testing when I googled. I can't see how this would be relevant if there is no comparison before I had all these symptoms.

My biggest concern is that because there seems to be no organic cause it will be put down to this anyway.

My last couple of appointments with Dr's I have been completley thrown off track as they have gone in a completley different direction to what I have expected, my list of questions that I have taken with me have become irrelivant and its only a few hours later that I have gathered my thoughts and have thought of the questions I should have asked.

One question I want to ask is "I have physical symptoms brisk reflexes and a droopying eyelid, plus a single lesion in the brain, can this be caused by a chemical imbalance?" I believe that the answer to this is "no" but I feel the need to bring it up, is that a good idea or not?

So has anyone been in a similar situation and can offer advice?

[twist330]

Thanks for all the info and support. I'm as ready as I'm ever going to be. So here goes, 9:30am tomorrow.

Thanks

[Ufrustrated2]

>>"chemical imbalance"

i often wonder if there is a test that conclusively shows a perfect "chemical balance" to compare us against to show to what degree of a "chemical imbalance" a person has.

[RedFlame]

I didn't have to write a paragraph either.  But I felt like I did hit my ceiling when he began reading these incredibly long sentences that made absolutely no sense to me.  I don't know if they were legal types of sentences or what, but he stopped after I coudn't understand 3 in a row.

[steph74]

I didn't have to write a paragraph.  I'm sure there are different types of tests that can be administered.

[supermum_ms]

I found a post i'd responded to a while back, same topic........

" I was tested, and even though it showed i had significant decline, with my new cognitive issues evident, i think it would of been much worse if i'd had the test early into the episode. I did not have ANY nouns but by the time i was tested (over 6 months later) i'd been working hard on getting them back so overal my results were better than they would of been. Hmmm even the writing part of the test would of been worse, my tremor had reduced and i could again hold a pen in my hand and write legibly, even if i didn't recognise my new handwritting lol

I use to know what all the parts of the tests were called and what they are determining but now i have to go and look them up, this should give you an idea of what to expect but remember there are various different tests that they can use, mine was a mini test, over in an hour, some are very detailed and last half the day. The WAIS-R is the most commonly used, i did a shortened version.

VERBAL

information: testing information - general knowledge eg capital city, name current events etc

Comprehension: testing practical information and ability to make social judgement eg why do we lock our front door.

Arithmatic: mental arithmatic, assess ability to reason using arithmatic eg how many 45 cent stamps can you buy with $2

Similarities: comparing items, assessing logical thinking eg how are an apple and pair alike

Vocabulary: definition of words, assessing ability to learn and use verbal information eg what is a guitar

Digit span: assessing attention and rote memory, 3 - 9 digits orally repeated forward and backwards

PERFORMANCE

Picture completion: assessing visual alertness and visual memory, eg find missing things in a picture

Picture arrangement: assessing ability to comprehend social situations, eg rearrange a sequence of pictures to make a meaningful story

Block test: assessing ability to think in a whole with parts and ability to think abstractly, little plastic red and white blocks, eg reproduce an abstract picture with the blocks

Object assembly: assessing the ability to construct a concrete form from its components eg mixed up pieces you put together to form say a cat

Digit symbol: assessing speed of learning and writing symbols, timed for 90 seconds to fill in a sheet eg a number is replaced by a symbol

It is easy and designed that way, no tricky question and you will not be able to tell when you have hit the ceiling of a subset or reached your limit of ability. If you do not have a prior assessment, then the presumption is that you are of normal intelligence and abilities.

One of the tests i did i'm not sure where it fits in, but i had to name an object on a picture, this showed my issues with nouns, the 4th picture and i could describe what it did, what it was made of, origin etc but drew a blank on its name, i did get a prompt of the first letter of its name, and then it was instant eg A = Accordian.

The other was to spontaneously write for 10 minutes, dont know why but i wrote about something my grandad did almost 40 years ago, thats just what popped into my head and i was writing very clear school print, nothing like what i teach/taught. My otherwise natural writing is loopy cursive and small, this was round, large and print, weird though normal apparently, though not for me.

Hope thats what you were looking for :-) "

You might also be interested in looking at the other posts on chemical imbalance, convertion, wishing well etc. Not that i think any of it is an issue you have but they are interesting discussions.

Cheers.........JJ

[PastorDan]

I don't even remember doing an essay, but it's been over a year now, so I can't say I didn't.

One thing I will say is that, if you are dyslexic, the neuropsych assessment should pick up on that very readily, and recognize that as a factor if there are any abnormalities in your scores that could be attributable to dyslexia.

My assessment confirmed that my physical issues were not imagined, and showed that I had impaired visuomotor processing speed.  The neuropsychologist explained to me that the specific shortcomings that they measured in me are clearly explainable by the teensy little lesions that the MRI had identified.

[jensequitur]

I've had the neuro-psych consult because I had identified cognitive problems.  I had to ask the neuro about it, and argue with him about it, because he seemed to think there was nothing wrong!  Well, the tests showed mild cognitive impairment.  So thhppppttt! to the neuro.

Usually psychologists/psychiatrists are pretty down to earth.  I think what he'll do is take a look at you, and send you back to the neuro to do his job right.

The essay - I wouldn't worry about spelling errors.  What they're looking for - and this is important - is to describe a picture in complete sentences, using proper English.  They want you to find everything in the photo and write about it.  I didn't use complete sentences, and so received poor marks - but the psychologist didn't include it in her report, as many people don't get that one right.

[twist330]

My neuro has arranged for this assessment, as although when I first meet with him 8 months ago he felt my symptoms were of an organic nature, having done all the tests  nothing has been positive enough to give a Dx and it appears he's the type that needs the black and white results which we do not have. So now he has told me it must be functional, although he has agreed that I do not appear "stressed, anxious, or depressed" he feels the neuro psychologist may be able to identife what pyschological issue took place to caused these symptoms.

He has dismissed the Dx of another GM doctor that I have RSD ( he had refered me to this guy for another opinion). He had arranged for a 2nd neuro to take a look at me but in honesty it was a waste of time as he simpled said if the test results do not show anything then there is nothing seriously wrong.

Yes,  I am fed up. Do I have a mental health issue? no.
I am more than happy to talk to the neuro psychologist, Hopefully it will discount the "chemical imbalance". I am concerned about being asked to write an essay because although I have a very high IQ, I am dyslexic and find it really frustrating.  

What concerns me is that the neuro wants "electronic" test results in order to make a medical Dx. Yet it would appear that one persons educated, but personal view will be enough to make a Dx of a mental health issue. Doesn't seem quite right does it?

Thanks to all for your info and reasurance it has been very helpful to me, and I can go prepared. I will let you all know what happens.

[Sparkysarah]

It feels as if you are very frustrated as there does not appear to be a simple answer and it becomes easy to vent the irritation at your neuro who you would hope would have the answers!.

I doe not know much about psychological assessment, but chemical imbalance implies to me that he is being thorough and investigating how you are feeling. It is often associated with depression. I would encourage you to not make any assumptions about where this is going, but just be yourself and answer the questions openly and honestly. It will not be a matter of getting it right or wrong as this is not the idea of the test..

I would guess that he is not suggesting that the root cause of your sx is a chemical imbalance..but that this may be a reason for any feelings of depression or anxiety. It sounds as if at the moment your sx are not all ticking the right boxes for any one illness/condition..and perhaps it is just that you are going to have to accept that you will have to wait in limboland for a while longer.  I am sure you do not want to hear this....but a neuro is not going to give a dx unless they are as sure as they can be.

I am not sure how many neuros you have seen but is it worth seeing someone else and getting another opinion?

I would go along with the testing, wait for the results, keep an open mind and keep a list of further questions.

I feel for you and send you strength and support

with best wishes

Sarah :)

[RedFlame]

Most likely you will have in 'interview' that will include clinical assessments performed through conversation and testing.  You will spend time just talking about how you have been feeling, he/she will ask about depression, anxiety, family issues and things like that.

You will have an 'orientation' part of the exam where he asks you the date, time, current president, counting---things like that.  He may do some testing with you such as the Rohrshack test---inkblot
some of the 'picture tests' that involve sequencing and logic.  

It's possible that he may send you home with a test called the MMPI which consists of 500 questions.  But that may not happen.

Just remember to relax and be yourself and be honest.  

It's really OK to have this testing performed.  It's in your best interest to get it over with, that way your neuro will feel more confident in diagnosing.

good luck,    lois

[steph74]

My experience with neuro-phych testing was that there were two main components to it.  They did a lot of memory/IQ -type testing and I was pleased to do this as a baseline against which to compare later.

The second part was the mood/psychiatric part where they test if you have an underlying psyciatric disorder.  Also very useful as I could say I was evaluated and given a clean bill of mental health.  

I'm not sure who you're thinking about bringing up the question to.  My neuropsychologist encouraged me to talk about my questions/issues/frustrations around the diagnostic process.  Assuming you have a good doctor, I assume this is a reasonable question to pose.  

Good luck.

Stephanie