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645800 tn?1466860955

NeuroPsych test...What a day.

Today was the day for my NeuroPsych evaluation testing. It was scheduled for 8AM at the Murfreesboro VA Hospital which meant I would have to get up at 5AM in order to get there on time. I had told my friend Dave that I had to get up at 5AM so what does he do? Calls me up at 4AM to make sure I got up. Oh was I foaming at the mouth mad about that.

Actually I didn't realize the appointment was at Murfreesboro until I was just about to leave so I had to quickly print out direction on how to get there. So I spent 5.5 hours there with all l but about 15 minutes being the testing and then the doctor going over the results with me.

The first hour was an interview type setting where he explained what was going to go on and asking me about the problems I have been having ( memory, vision, OCD stuff, family history, etc). The doctor was real nice and had done his homework in studying my medical charts. He also seemed to be vary knowledgeable about MS.

After about a 5-10 minute break while he set up the stuff for testing me came the real workout. By the time we finished with the tests I could barely focus my eyes and at the end of the last test he said he could have done more tests but could tell I was having trouble with my eyes and getting really burned out.

I forget how many different tests we did, but they cover visual memory, hearing memory, recalling with clues of my memory, Timing the response of each of my hands,  Figuring out patterns, etc.

In the end he said my memory was fine once I get things in there, but am very slow at getting them in which is consistent with MS.

He said my right hand was 25% slower than my left even though I am right handed which he expected since  I had my brace on my right foot for the foot drop. When I have looked at my MRI pictures I had noticed most of the spots were on the left side of my brain.

I was surprised I did good on the math skills part. They word those word type math problems which he read to me 1 time only. You know the "if you have 3 apples and your friend has 2 apples and you give him one apple how many do each of you have". I missed only two of the questions mostly because I forgot how many where the original amount.

For figuring out complex things I could do it but it took longer than it should have based on my age and background. Again consistent with MS. The brain is just slowed down.

As for the OCD type things I have been experiencing he said there is a component of that happening that could be either anxiety or memory problems, medication, or both. He is going to recommend a review of my medications and talk therapy so that it doesn't get any worse. Since I live so far from th VA hospital he wants to see if he can get something like weekly teleconference therapy and monthly in person therapy.

He was also concerned about my sleep problems and was going to put in for some pain management type stuff to go along with the talk therapy as the OCD stuff is also disturbing my sleep.  That sure would be great as I can't remember have even one day free of pain since 1989. I think he said that because I admitted that once last year I was in so much pain and depressed I though of shooting myself in the foot just to get some pain medication.

Speaking of pain about 1 hour before the end of the testing I had another bout of TN start up. Of course I had none of my pain meds with me so by the time I got home I was in agony. I took 2 pain pills immediately;y when I got home so if this is not readable you will have to understand it is the pain meds kicking in. Now I ma going to got to sleep about 20 years as I can hardly keep my eyes open any longer. Besides All that I have written is just a big burr and am just using the spell checker to guess at what I had meant to write. Thank God for the read underlines. :)

Dennis


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Avatar universal
LOL - reminds me of my disfunctional cognitive.  I love to play bingo online and lately can't even make it thru one game; I "phase out" and just forget to look for the numbers.........that was when I really realized I had trouble concentrating, and wasn't taking any meds......am definitely putting it on my list for the MS specialist in Oct.

Ear Plugs....gotta try that one......loud noises startle me really bad
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338416 tn?1420045702
That's entirely possible!  
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645800 tn?1466860955
I was on Aricept for several month years ago for the cognitive problems but found no improvement while on it. It may have been that I was in a fairly bad flare at the time, or that my mind was being effected in a different way than yours was as to why it didn't help me.

JJ did an interesting post today on Cognitive problems for people with MS. My problems according to the testing I went through are linked to the 4th type where everything is working slower.

Dennis
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620877 tn?1282764097
The only thing that sticks in my mind about the neuro-psych eval I had about a year ago....how utterly exhausted I was at the end!  Glad you made it through, Dennis!  Sounds like it was very thorough and hopefully can be helpful with some of your issues.

Hugs!
Chrisy
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338416 tn?1420045702
Dennis, I went through about two bad years of that - not remembering what that thing is to mash the potatoes, or what you use to heat food, or keep it cold...  It got to the point where I had to point and grunt at the thing I was talking about, because I could never find the word without several minutes of thinking about it.

Planning tasks was even harder.  Even Hamburger Helper got messed up.  I couldn't cook at all, couldn't figure out which thing to cook first.  Making change was impossible.

I wasn't dreaming, either.  Each night started soon after I got home, and I slept very late, until it was almost time to get up and get ready for work.  Sleep was a giant black hole every night.

It got to the point where I was afraid it was going to affect my job, so I got that neuropsych exam.  The psychologist recommended Aricept,  so after some arguing with my neuro, I got a sample of it for a month.  To my surprise, it actually helped.  It was rather like when your shower head is clogged with calcium, so you turn the water up, and the water that does get out of the head is stronger, so you can get clean.  It felt like my brain was jumping over the holes.  Eventually my brain learned new ways to get around the holes (kinda like remembering where that pothole is in the road, so you don't run into it every single time.)  I took it for five months.  

Every time I ran out, I waited a couple of days to see if my thinking changed.  After five months, it didn't get substantially worse without the drug, so I stopped taking it.  If that makes any sense.  I could tell I was still having problems, but I was more confident that I could handle it.

Most importantly, I started dreaming again.  At first they were very boring filing dreams - looking for that piece of paper, trying to fit everything in a hole, not making it in time for a meeting, but they began getting more interesting as I started to feel better.

I don't recommend Aricept for everyone.  It's possible that I just got better on my own.  I haven't found a neuro yet who agrees with using Aricept for cognitive problems.  But it's worth a try if your neuro is receptive.
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987762 tn?1671273328
COMMUNITY LEADER
Neurological basis of learning difficulties

Language can be perceived in one of two ways: through a visual medium such as reading words on a page or through an auditory medium such as listening to a teacher speak. Children with learning difficulties often do not experience problems with their eyes or their ears however, their difficulties are the result of how their eyes or ears process the incoming information and is relayed to the relevant part of the brain. Learning difficulties originate in the brain which is why they are often referred to as developmental disorders with a neurological basis.

Some features of every type of learning disability can be related to the ear, the auditory system and auditory processing. The two organs in the inner ear play a pivotal role in learning. The cochlea attends to every sound in the environment and it is the organ of hearing, while the vestibule is the organ of motor balance, coordination and sensory integration – for example, the vestibule plays a significant role in reading by controlling the visual tracking ability of the eyes.

The multitude of problems experienced by children with learning difficulties starts to become clearer when the role of the inner ear is explored in detail. Fine motor coordination is essential for legible writing, accurate auditory processing is essential to learning language well, strong visual tracking enables reading, and a well-functioning brain depends on a strong neural network. Because the cochlea and the vestibule share some of the same anatomical components it is not uncommon for language (cochlea) and motor skills (vestibule) to demonstrate parallel strengths or weaknesses.

Children with learning difficulties often tend to display abnormal listening patterns, difficulties with language acquisition or poor skills with verbal or written language, poor auditory memory and inattentiveness to verbal language. This is not to say that their hearing is affected – instead they may show errors with sound discrimination or sequencing sounds in words, inconsistent responses to auditory stimuli and trouble with associating sound with their written symbols. This is reflective of a dysfunction in the way the brain is processing auditory information and helps to explain why language is frequently affected, as verbal skills are first acquired through listening to speech sounds.

************************

OK i know this is relating to children but the basics are still the same, neuro developmental pathways, (we have holes in out pathways lol)  you'll actually find a lot of helpful tips within LD, NVLD, ADD, ADHD, CAPD, Dyslexia etc sites. This stuff is what i've been doing with my self for the last 20 years, i've got tonns of it.

Cheers.........JJ

Site: http://www.listenandlearn.com.au/disorders_LD.asp
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645800 tn?1466860955
Well in my case it probably would be Central Brain Processing Disorder. LOL

Not only do I hearing things like you suggested I also read things like that. I remember driving past one craft store down in Florida almost every day. They had a large sign in the window that said "We have beads of all types". But for quite a while when I drove by the window  I kept reading the sign as "We have beds of all types". There are other examples of this but can't think of any right now. I have made it a rule for myself to always read everything at least 3 times just to make sure I read things right. IF 2 times are the same and the third is something different I know that what I read is really the one that repeated twice.

Dennis


Dennis
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645800 tn?1466860955
You reminded me of one of the first times ( back around 1990) that I didn't recognize a street. I had taken my daughter out for Trick Or Treat along with some of her friends. As we lived out in the country ( sort of ) I was driving them around the neighborhood when all of a sudden I had no idea of where we were or how to get home and had to ask my daughter for directions to get home. At the time we were only 2 blocks from home  and I only need to do was make 2 right turns. I drove straight home and let my ex finish taking them around for trick or treat.

These recent recognizability problems each lasted for over 1 hour each. So they were definitely more scary. especially since even after coming to the realization that the car was mine it still did not look familiar.

Dennis
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987762 tn?1671273328
COMMUNITY LEADER
Has anyone ever mentioned Central Auditory Processing Disorder (CAPD) to you?

In simple terms its when your hearing isn't a problem but the sound you hear gets confused by your brain. Sort of like putting the sentence in a blender brain and then you end up comprehending the sentence either out of order or just bits of it that are hard to make sense of. Music is often unaffected but sentences are a major problem.

Just a thought...........JJ
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1658667 tn?1310091382
Thanks Dennis. That is funny you mentioned not recognizing your car. I had this happen to me coming out of a business meeting. It only lasted a few seconds but it scared the begeebies out of me.

I then didn't recognize a client...you can imagine how embarassing that was. And then not more than a few days later I didn't recognize a street near my house and missed my turn.

That is one reason I asked for the neuro exam because there is Alzheimer's in our family.

I appreciate you sharing all you did. It is really helpful.
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645800 tn?1466860955
I don't think that would work for me very well. Being a big music lover ( composer/songwriter) if there is music going on my mind automatically switches to the music instead of what I should be concentrating on.

Dennis
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645800 tn?1466860955
You mean you can decide what to do first? LOL

I have a horrible time making any decisions at all. It has been several weeks since I looked for a ---- (can't think of what is is called right now) to help me wash my back and still haven't been able to decide on one.

Too bad ear plus won't help me with remembering what is going on during a movie I am watching. A lot of the time I end up turning off movies because I have lost track of what was going on after only about 15 minutes.

Dennis
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645800 tn?1466860955
My Neuros ( I have more than 1)  believes I have SPMS but they have not been able to see any lesions in my brain so they are not comfortable to say I definitely have MS. My dad also had MS but did not get his diagnoses until he was around 65 because lesions didn't show up until then in him. But I do clinically match the criteria for MS. Maybe with measurable findings from this test my VA neuro will finally get of the fence.

The VA Neuro sent me for this testing because I started having trouble recognizing things I should recognize like my own car or the number three. Since the doctor that did the test mentioned that there was no indication of Alzheimer's I suspect my neuro was concerned that this might be the onset of Alzheimer's. But the testing showed that this was not the case but was suggestive of MS.

Dennis
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1394601 tn?1328032308
I might mention to Dennis that my LD son found listening to music with earphones useful if he was trying to concentrate.
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1394601 tn?1328032308
I had to laugh because when my boys were all young I wore earplugs all the time.  My friends would roar laughing but I was probably one of the calmest mothers...cause I never heard it all...lol

Thanks for bringing back that memory for me.
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1658667 tn?1310091382
Dennis- I saw on your profile you are un-dx. Does the neuro psych feel this will help with a firm diagnosis of MS (or something else?). How did it come about that you went to have this testing done if I can ask?

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338416 tn?1420045702
Yup, sounds similar to the problems I have!  I've discovered I can't do anything without writing a list of what to do first.  I can't figure it out without a list.  And distractions can really throw me off.

I find I work better with earplugs in.  If there's too much noise I can't concentrate.
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645800 tn?1466860955
He gave me some of the results while talking to me for about 1/2 to 3/4 hours after the final test. The final results should be ready in about 1 week.

What is going to be tricky for me is that he said I should repeat ( say again, have repeated to me, write down ) things about 5 times to help me remember things. But he stressed that I should not do this too much because I have an OCD component going on at the same time and this could become a real problem for me. This is the main reason he wants me to get therapy.

He also said I was having a little bit of a problem with getting things categorized in my mind so the categorization / word association thing will not help me much. Doing the categorization gets me into doing too much at the same time so things become harder for me to remember if I do that. The tests show that the more I have to do at the same time with my brain the worse I do ( ie slow down) . So I do fairly well in the controlled environment of the test but it real life with all of the noise and distractions everything becomes a big problem for me. Guess I need to get myself in a bubble to keep life out of my life. LOL

Dennis
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338416 tn?1420045702
Hey, Dennis, has he given you the results yet?  Or are you still waiting on his analysis?

These tests are amazingly comprehensive.  I expect you'll get some good information on your deficiencies, and what you can  do to strengthen them.

Me, I found that my usual methods (nonexistent!) weren't going to work in memorization.  I had to make an effort to remember things - either through categorization or word association.
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1658667 tn?1310091382
Thanks Dennis :D
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645800 tn?1466860955
No they don
t do a full neuro exam. They are only concerned with thought processes.

I did forget about one other test he did. He gave me two long lists of words that I had to read aloud to him. After reading the lists I kidded the doctor about some of those words must be fake words. Very hard for me to pronounce.

Also with the tests were he timed how long it took me to do the pegs in the holes for the right hand I had to do the pegs like you read words ( left to right) and with the left hand right to left. So again it was about thought processes.

Dennis
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1658667 tn?1310091382
Denis- Yes thanks for the details!! It really helps to know what they are going to do.

Did they do a full neuro exam with reflex testing and walking ect.?

Sumana- Samer here with my son. When he went to college he finally got the extra help he needed. He is graduating this year and doing very well. It was very frustrating when he was younger however. He was not a "bad" kid but got bored in class because he couldn't learn like the others. I am glad things have progressed in cognitive testing.
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1394601 tn?1328032308
Dennis, thank you for sharing!  I have never had that type of testing but wow!  what we could learn about how our brains are working!!  I have a son with learning disabilities.  It would take him about three times longer to complete tasks at school.  Too bad these tests weren't available back then.  It would have shown him where some of the problems were...I think an LD kid would have found it useful.  You know sometimes he just would feel stupid because his brain didn't operate like others...

It doesn't matter.  He beat the odds with a lot of discipline and hard work.  He has graduated from college and holds a good job.  He was one of the few lucky ones.  He had a lot of support.  Of course, the LD didn't disappear.  He still has issues.  I may talk to him about the testing.  Even today it may be helpful.

Again, thank you for sharing.
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645800 tn?1466860955
It is kind of complicated. I was at the exam for 5.5 hours with about 15-20 minutes for breaks in total.

The first part lasted about 1 hour with a kind of interview type setting going over history, symptoms and the like plus the doctor explaining what was going to happen. Basically getting to know you thing so that he can figure out what tests to give you and what your concerns are.

After that there are many different tests that last between 5 and 10 minutes or so. but some like the memory type tests are repeated to some extent all during the total testing period.

For example in the one memory test he slowly read a list of about 15-20 words that you are to memorize. after you try repeating back as many words as you can remember he went on to some other tests and after 10 minutes went back to the list and have you tell him what words you remember again. After that he reads the list 4-5 more times more times and you tell him what you remember after each time. This tests how easily you can get the words to stick in your memory. he then reads you another list of words  that you have to tell him what you remember. After that you do more tests and then he come back and asks you to tell him what was one the first list. This is to test how well you can sort your memory according to categories ( first list vs second list ). I actually did switch some of the words for the different lists  At other times he will ask you to tell him what were the animals, furniture, etc on the first list. This he also did several times during the total testing time. At another time he would give me 2 words and ask which one was on the first list ( tests how good you are at recalling things if given a clue ).

he also did something similar with a set of 50 pictures. After showing you the 50 pictures he would show you a set of 2 pictures at a time and you had to tell him which of the 2 pictures were in the original 50 pictures. There were about 12 picture I did know which one was right but guess correctly about 50% of the time.

In another test he would show you 6 stick type drawings and then you would have to draw them on a paper in the correct order. he did that about 4 -5 times in order to see how difficult it was for you to remember visual images. Each time I was able to draw more of the images but never was able to get all six of them. The first time through I could only remember 2 of the drawings.

In another test he had these red and white colored blocks that you had to arrange to match patterns you were shown. Each pattern was a little more complex and I slowed down significantly on the more complex patterns in arranging the blocks.

For testing my hand response times there were two tests. The first was a counter you had to press as fast as you could during a certain amount of time. I could click the counter a lot faster with my left hand than I could with the right. The second test consisted of a block with about 25 keyhole shaped holes in it. He then timed how long it took for me to place all of the key like pegs in each of the holes. Again my left did a lot better.

There were also a few tests that you did on a computer.

The first one was a list of about 10 word pairs. The pairs were things like on one side would be "Ice" and the other was "Cream"  The computer displayed each of these pairs twice and then you had to pick from another set of 2 words which was the one on the lists they had shown you. This test was to test how well you associate words and I did very good on it.

The second computer test consisted of 4 blocks on top of the screen each with different colors, number of symbols, and type of symbol.  It then brought up one at a time other blocks for you to figure out what why to match the new blocks to the 4 on top. ( color, shape, or number of symbols) by if you selected the right or wrong one of the top 4 blocks for the match. This was to test you ability to solve complex problems. The program running this test would switch what it was trying to have you figure out ( color, number, or symbol)  every so often. I was very slow to figure out the problem at first but after a while got it.

I probably left out some of the tests but this should give you a good idea of what it was like.

Dennis
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