neuro psych testing

Hi Everyone,

Did anyone go for neuropsych testing prior to definitive DX? My doctor send me due to all the brain lesions, still not done with it, probably will have two more appointments.
I am asking because I wonder if the dr. uses this to try to help with DX even though it is not part of McDonald criteria.

[jreagan70]

I am asking because I wonder if the dr. uses this to try to help with DX even though it is not part of McDonald criteria.

You're right. Neuropsych testing isn't part of the McDonald criteria and isn't even part of the diagnostic process for MS. The testing finds out only if something is wrong but can't tell why it's wrong. So even if deficiencies come up with the testing, they can't be definitely attributed to MS since there's no way to do that.

Neuropsych testing is usually done after diagnosis as a basis for something else, like a disability application.

Your doctor may be concerned that the brain lesions might have caused some cognitive/psych issues for you, but the testing isn't diagnostic. You'll have to ask your doctor why s/he ordered the test.

[22cyclist]

There are certain tests within the battery of MS testing that looks for increased latency in responses to certain questions or within certain games. These are specific for MS and therefore the along with your MRI, the neuropsych can tell the neurologist where the weaknesses are coming from. So to answer your question, even without an MRI a neuropsych test can tell the examiner and thus your MD if your cog fog is looking like it is coming from if it is MS.

Good luck and let us know how it goes.

Lisa

[MSW1963]

I was given the impression that the results of a neuropsych evaluation can support a MS dx, rule out if a specific sx is neuro related or due to depression for example. Also collaborate if my 'getting lost in familiar places' is visual spatial skills deficit that is MS related or anxiety/depression.

I had my first neuropsych testing pre-MS dx and another 5yrs after MS dx. Nueropsych evaluation also provides a baseline for deficits to compare with evaluation later to determine rate of decline.

[jreagan70]

Hi jskmssss:

I'll expand on my previous answer. There is no test, in and of itself, that is diagnostic for MS.

In making a diagnosis, an efficient and prudent doctor does tests to narrow the possibilities to a particular condition, not does tests that just confirm the broader list.

Since latencies were mentioned, there is no test that can say that the latency is caused by MS specifically. There are tests that find and quantify latencies, but there are many conditions that cause latencies. So there is no test, no question on a neuropsych test or evoked potential or anything else, that can point specifically to MS as the cause of the latency. Plus, a neuropsych eval is a very lengthy process to do to look only for a small subset of results. There are more efficient tests to look for latencies as part of a diagnosis.

So even though there are certain tests that deliver results that MS can cause, there is still no way to use those results to narrow the possibilities to a specific diagnosis -- including MS -- from other conditions that also can cause the same kinds of results. MS isn't the only one.

So no matter what your neuro has in mind, the possibilities all have standard protocols for diagnosis. A neuropsych test may have questions that are designed to find deficiencies that MS can cause, but other conditions like MS can also cause them, so it isn't specific enough of a test for using as part of the diagnostic process for MS. If neuropsych testing were specific enough for making a diagnosis of MS, it would be part of the diagnostic protocol for MS. That it isn't tells you how unusual your neuro's approach to diagnosis is.

Again, neuropsych testing has sections that evaluate the kinds of results that are characteristic of MS and MS-like conditions, so it is more often used to document the effects of MS after diagnosis.

The reason your neuro referred you for testing is something s/he will have to explain. Your neuro should already have the results of your MRIs, physical exam, and -- if s/he wants more corroborating evidence for MS -- other tests specifically associated with MS, like the battery of evoked potentials, LP, possibly OCT, as well as the results of other tests that point away from MS as rule-outs. Neuropsych testing doesn't add anything diagnostically that your neuro shouldn't already know.

Neuropsych testing to look for yet more information outside the protocol of MS diagnostic testing is unusual and particular to your own neuro. Certain doctors have tests they just like to do as a part of the way they learned to think about a particular condition. Through all of the neuros I've seen and all of the MS diagnostic literature I've read over the years, not a single neuro would ever include neuropsych testing in the information they use for making a diagnosis.

[msgijo]

I had one two months ago and really wish one had been done 20 years ago.

It was kinda interesting (in a nerdy sort of way) and is one test that doesn't hurt or cause any neg effects (unless you end up with a headache from trying to do math in your head).

I haven't received the formal report from mine yet, but was told after testing was done that she saw some deficits but that overall I appeared to be in the "normal" range. That is why I wish that there had been a baseline from 20 years ago - because I KNOW that I have diminished cognitive function.
Guess I must have been a genius in my day?

[SNOOPY]

Hi jskmssss,

I have had MS for many years but only had neuropsych testing a few years ago.

I found Neuropsych testing to be quite interesting and exhausting. Neuropsych testing assesses Cognitive Function/Dysfunction. Unfortunately, testing may not give you a diagnosis but it can tell you if you have deficits and give a possible plan of action, if needed.

A referral for Neuropsych testing is done for many different reasons.

The neurologist's expertise lies in diagnosing and treating the structural and physiological consequences of brain injuries and neurological illnesses. In contrast, neuropsychologists assess the effects of brain injuries and illnesses on cognition and behavior; they are experts in assessing functional capacities.
http://www.psychologistanywhereanyti...euro-psych.htm

[jskmssss]

Snoopy, Jreagan, msgijo, 22cyclist,

Thanks for taking the time to respond. Unfortunately, my testing so far is showing deficits. I was happy when he told me it is not showing signs of dementia which was one of my fears. I am anxious to get this all done and see if the neuro comes up with any answers.

Much appreciation for your time.