Neuropsych Eval Anyone?

[woodstock]

I was dx with CIS/RRMS at the end of Summer 2011 and started on Copaxone 3/31/12. My initial MRI showed 5 lesions, 2 measurable in the brain and the repeat MRI in October showed no appreciable change.

Since way before dx, I have been having cognitive issues that I thought were related to ADD. My pcm had me on Ritalin for several years until I moved and not knowing how to pursue a re-dx, I waited until this year to go back on a medication which is now Vyvanse.

I'm just not having the success that I expected. And in retrospect, I've been having issues for about the past 9 years. I can recall going to my doctor specifically because I was having memory issues that were concerning such as forgetting the names of people I worked with for years, blanking out on exams (I was trying to work on my Masters Degree at the time), forgetting words, etc. I just felt "something" wasn't quite right. He played it off as I was hitting 40 and it was part of getting older, possibly related to pre-menopause (which 9 years later I still haven't hit yet), etc.

Over the past couple of years, the cognitive sx have gotten worse. I lose things, can't stay organized, forget things, etc. Just before the flair that got me dx and about two months afterward, I went through times when I couldn't remember words, though I could describe what I was trying to say. I feel like I stumble through conversations. Hubby describes it that it takes me 15 minutes to have a 2 minute conversation. It takes me forever to complete tasks, if I am able to complete them at all. Etc...

I've decided to pursue a neuropsych evaluation even though the psych I currently see for the ADD meds dismissed the idea. He told me that only someone who wants to go out on disability would get a neuropsych eval. I want to find out if my sx are related to the MS or not and what to do to work around them.

Has anyone had similar sx and done a neuropsych evaluation? If so, what was it like? What should I expect?

[tambrown]

I wish I had answers for you . I will be watching this thread as I have never heard of a neuropsch eval . What is different to see them or is it not a person just a test .
Take care an I hope you get answers soon . Tammy

[deb46]

Hi woodstock. I have all of the same symptoms you do. I had a neuro psych eval several years. During mine they gave me a written test with multiple choice questions. Then they gave me an oral test to see if I could remember things they told me.

I did have some issues according to the test. My memory has got a lot worse lately so my neuro just this week ordered another one.

I can't remember peoples names or the name of objects. I tend to say words backwards or can't get them out. People are use to helping me finish my sentences. I also have trouble reading. I can read a sentence and it just doesn't sound right. I can read it over several times until I finally find the word I am miss reading and it is nothing like the word that is really there.

Sometimes I start to go places and can't remember where they are and have to drive around looking for them even when I have been there many times.

I also can't spell anymore and I use to be very good at spelling. It is really very annoying and I get upset because of this. I told my daughter the other night I thought I would just put a piece of duck tape over my mouth so I couldn't try to say anything.

The test is not bad at all although it takes several hours. Wishing you luck!!

[lemstar]

My husband is a psychologist. A neuropsych eval tests different cognitive functions, and the goal is to pinpoint basic cognitive skills and assess them, and to obtain a baseline for future comparison. It will test memory, some comprehension skills, some expressive skills, etc.

I think it might be helpful for following a patient, and having some objective measures to compare with future assessments. However, there is no magic bullet, or mysterious brain information revealed from this. It can have implications for medications, and for trying to work on areas of weakness to keep them as strong as possible. We can also develop compensatory strategies for our areas of weakness when we better understand them.

Does this help?

[oso49]

I, too, have the cognitive issues mentioned in the threads and recently have noticed that I'm not quite as quick getting around on the computer key board as I was in the past. (I can't find the keys as quickly as I used to). Anyway...

I have a comprehensive neuro psych eval scheduled for the end of the month. My neuro at the Shepherd Center told me, as lemstar eluded to, it will establish a baseline from which she could compare to subsequent evals to help determine "progression" of this wonderful gift we all have...

I can hardly wait...

The best to you all...

[Maggienor]

Neuropsych Eval

I had this test done in Nov 11, and let me tell you I can see why I am having trouble at work. Concentrating and just simple problem solving.

I work in the accounting field and things I did on the computer in the morning, I forget how to do them in the afternoon, I have to ask for help. Luckily my coworkers know and they help me out.

I am thinking about trying to apply for disability since I cannot keep up and it puts more stress on me which gives me symptoms. It is good take this test to know your compasity for working. Since I work with numbers on a daily basis it's hard to keep up.

I can use this test to help with my case for disability. I have been working 36 years and I think since being diagnosed last year my endurance is not there and the fatigue is terrible. Much luck to you and I would advise you to take the test it may help you.

[JayEm]

I had a neuropsych evaluation last month. The neurologist ordered it, I think mostly to see whether my perception of having cognitive impairment was correct.

It started with an intake, which took about an hour. The psychologist asked me a lot of questions about my medical history and my... I guess social history (things like what I'd been doing with my life, and who I live with, and why I made decisions I'd made, and things like that).

Then there were two days of testing that included all kinds of things. The main tests I remember were IQ tests, memory tests (remembering strings of letters, or being able to recall the details of a story both right after and then after having done something else in between), tests of concentration, and this one where I had to put pegs into a board. Oh, and one where I had to figure out what small objects were with a blindfold on.

She was able to confirm that while my intelligence seems fine, my memory and concentration abilities were much lower than expected.

As others have said, this is better for establishing a baseline, but the evaluation can also be used to pinpoint areas to focus on learning skills to compensate for things that aren't working as well as they should.

I don't know if it's because I'm not diagnosed with anything physical, or because I have a mental health diagnosis, but she also spent a lot of time on an assessment of mental health.

The psychologist might also want you to come to the initial appointment with someone who knows you--she asked me to do that, but unfortunately, my partner couldn't take time off from work.

Good luck. The tests can be long and tiring, and frustrating, but it's helpful to get a better sense of what's going on.

Oh! And as for this:

I've decided to pursue a neuropsych evaluation even though the psych I currently see for the ADD meds dismissed the idea. He told me that only someone who wants to go out on disability would get a neuropsych eval.

I got the neuropsych evaluation even though I've been on disability for several years now. I wanted to figure out what's going on with my brain, and hopefully figure out better ways of compensating for the problems I'm having.

[Toomnyhats]

It's not quick but it is painless!

I had this done a year or so ago. Most of my sx are cognition/vision as opposed to mobility so I wanted a baseline. I had noticed many of the same issues you have - short-term memory, word recall, problem solving, trouble focusing, putting the milk in the pantry, etc.

As others have said the testing took several hours. I was exhausted by the end & my brain was tired

The results: "You're not as bad as you think". Doc "prescribed" luminosity.com brain games 45 min/day 3-5 day/wk. If I do this regularly I notice an improvement in my cognition. Problem is finding enough time to do it

[KyleW]

I had a neuro psychological\cognitive eval as part of the initial assessment at my MS Day Spa.

The good news is that I'm average. The bad news is that I'm average I was not having any significant cognitive issues but wanted to have a baseline established just in case.

Kyle

[LisaL77]

"My MS Day Spa"

I would hoot with laughter, except I am at work. That is precious.

I might request a neuro psych eval Tuesday when I see my MS Day Spa Esthetician also known as my Neurologist.

Cognitively, I am experiencing the following:

Word substitution that sounds like the word I am looking for, but the meaning is unrelated. Ex: I told a colleague that a change in weather prompts a change in BARIATRIC pressure, which can cause sinus pressure headaches. I meant Barometric, and the word came to me 3 days later. I used to dance around and use a word that closely meant what I was trying to say, now I really screw up. LOL

Walking into a room to get something. Completely forget what I am searching for. Same at work. I turn from one side of the desk to another to perform a small task. Forget immediately. This should bode well on my next performance evaluation.

Locations: I can picture where my doctor offices are, but if you ask me to describe how to get from one spot to there, I can't. I use my Garmin a lot.

Names of people I've known for years. Well, you guys know how this one goes.

My husband repeats statements to me. Oddly, he has been HORRIBLE about remembering things I tell him 2 and 3 times. He got annoyed that I forgot he communicated to me he was going to play guitar at open jam. I replied "Now you know what it feels like to repeat over and over to someone." He said "But you are never like that."

Problem solving skills: Seriously, I feel dumber. Like my creative thinking/puzzle solving skills are gone. Wondering if I can do this job anymore.

Watching a series, reading a series: I cannot remember what happened in the last episode. Also, the characters are hard to identify/remember.

[KyleW]

"My MS Day Spa"

I would hoot with laughter, except I am at work. That is precious.

I'm only half kidding You should see this place. Everything the well attended MS patient could want, all under one roof!

Neurology, physical therapy, cognitive therapy, psychological counseling, Naturopathic doctor, infusion center, MRI suite...

http://www.imsmp.org/

[woodstock]

Thank you everyone for your feedback and support. The first appointment is a meeting with the neuropsych where I believe he'll get a history. I am to take my MRI results with me. Based on that, he'll decide which tests I should take and will work with my insurance company to get them approved.

I have mostly cognitive stuff going on. If I don't take the Vyvanse in the am, I can't focus at all. Even with it, there are many times I've noticed that I will be looking for something (an object, a specific piece of paper, etc...), it will be right in front of me and I won't see it. I've known for example that my keys are on the counter, have looked there 2-3 times and not 'seen' them, keep looking all over getting more and more frustrated, and then finally they will 'appear' to me. That's been very odd.

There have been times when I have forgotten which keys to type on the computer (and I've been typing by touch for over 30 years). And, there are times when I can't compose a sentence or email (and I've always been the queen of good writing). All of this is extremely frustrating.

On top of that, I'm a guidance counselor and I am so concerned that with my concentration and memory issues that I may miss something with a student that could be critical. I want this evaluation so I know what my real deficits are and see what I can do to learn to work around them. I also don't want to get to the point to where I make a serious error before realizing that it's time to quit working.

[JayEm]

Walking into a room to get something. Completely forget what I am searching for. Same at work. I turn from one side of the desk to another to perform a small task. Forget immediately.

I read something recently about how this is related to our (by this I mean "humans'") brain organization. It's as though by moving from room to room, or place to place, we move into a different "folder" in our brain's computer. If you repeat what it is you're about to do as you cross the "threshold" of the new spot, you're more likely to remember it. I know that trick has helped me.

With my neuropsych eval, she took into account the difference between my IQ and my performance on the memory/concentration tasks. She said that while those were in the just-below-normal range, and might not otherwise be a concern, the fact that they were a lot lower than my IQ score would suggest indicated a problem.

It was both reassuring and upsetting: reassuring that I'm not imagining it, but upsetting that there really is a problem.

[lemstar]

I'd also like to remind everyone here who is over 50 that age can play a part in this too ya know....my MS specialist mostly just smiles at me when I tell him about my forgetfulness. I am not negating the validity of anyone's cognitive struggles, but am pointing out what we hear a lot: its not always the MS.....

[woodstock]

I agree with you Lemstar and realize that age can be a factor. I'm 49, so I know some of this comes with age. I would just like to figure out what is normal and what is MS. I suspect that quite a bit is actually MS since I've had these symptoms for more than ten years now and at the times I sought treatment back then at the end of my 30's/beginning of my 40's it was chalked up to age/possibly entering pre-menopause. At 49, I am still waiting to enter pre-menopause which my mom didn't enter until her mid 50's, so I really don't think that's the cause of alot of my sx.

The not seeing things that are right in front of me, that I know were there, until I've looked in the exact same spot multiple times...that just doesn't seem like a normal sx of aging. And, the vocabulary gaps that I've had since my late 30's, that too is something I don't think is age related.