What tests are there for concussion?
 

Hi been following the posts for some months now and was wondering what tests are there post (3 months +) for concussion.

CT scans and MRI from what I can tell rarely pick up most of the symptoms experienced by users on here.

There is the mini–mental state examination (MMSE) or Folstein test which is mainly used to test for dementia. Which is somewhat trivial - what season are we in, what room are we sitting in. Although, I got stuck on spell WORLD back wards could not do it:confused:

The other one seems to be the MMPI Minnesota Multiphasic Personality Inventory. Which again seems to test for depression, anxiety, hypochondria etc.

Are there any other recognised tests available ?

Apologies if this has been covered previously

There is a specialized MRI called Diffusion Tensor Imaging that can show damage from a concussion. qEEG's can reliably (97+%) diagnose a concussion if compared to a reliable TBI/mTBI database.

The MMSE can show symptoms of concussion even though many practitioners mutilate the MMSE expecting the same reliability.

The MMPI can be used to diagnose concussion if the scoring is done using the Cripe Neurological Symptoms index. This is very rare.

The Halsted-Reitan battery of NeuroPsychological Assessment tests can be accurate.

Those that work best are not well appreciated. Attorneys try to discount them in litigation.

The question is, What are you trying to get the diagnosis for? Any of these accurate diagnoses without proper presentation will be discounted.

Thanks for the response

Currently my doctor will not advocate any treatment / therapy until he receives guidance from a specialist as to which way to treat me. At the moment I am being treated for "headaches" despite displaying other symptoms. His advice is to only take paracetamol and sit it out. This is literally a painful position to be in as I am stuck in a "no mans" land of not being able to work, not being able to prove I can't work nor have access to any means to get better. With lack of Neurological services where I live in the UK I have two options:

a) wait for the Health service here in the UK to provide me a with Neurologist review. However they want an MRI scan before seeing me. Then they will undertake their "assessment". This is unlikely to happen until November / December

b) To see a private ( where I pay $350 per hour) Neuropsychology who will run some "tests".

The majority of the assessment I have seen examples of are really basic Andi want to analyse mental happiness rather than capacity or capability.

So my question is what are these "tests" and how conclusive are they and from these can they determine a severity / permanency / likelihood of recovery etc? Perhaps hoping for too much :)

These tests can not prognose recovery or time to recovery. The only way to treat concussion is by individual symptom. There are no treatments for concussion. Anybody who makes promises about treatment or recovery is outright lying to you.

Sorry, but only time helps with recovery other than a good diet and avoiding bad foods and over-stimulation. Quiet rest is the only proven therapy.

There is also this:

http://edition.cnn.com/video/#/video...ye.tracker.cnn

fMRI, SPECT & PET scans can also diagnose post concussion syndrome depending on where the problem is.

fMRI, functional MRI is still used primarily for research. The brain mapping feature of fMRI is a much more expensive way to get the brain mapping information available from a qEEG. The qEEG comparative databases have been built over decades. fMRI is analyzed individually where qEEG uses computer software to greatly expand the data set. Finding a doctor who will use fMRI to accurately diagnose concussion is the biggest difficulty that, when added to the cost, makes it an unlikely diagnostic procedure.

SPECT (Single Photon Emission Computed Tomography) and PET (Positron Emission Tomography) is another expensive way of mapping brain functions usually based on the metabolism of short life radioactive glucose. Both are better at excluding problems that diagnosing the conditions from concussion.

I have had all of the imaging processes except fMRI. I have also has MRI/MRA to image blood flow with greater definition.

The greatest amount of information came from the qEEG. Unfortunately, qEEG has still to overcome a negative article written in 1997 in the Journal of The American Academy of Neurology (AAN) and read by many neuros. Even though the negative article has been soundly discredited, the neurology profession has not had access to the plethora of articles written by neuroscientists in support of qEEG. As such, it is difficult to get a health insurance company to pay for it.

The best source of qEEG is in the neurofeedback industry. The important consideration to understand is which, if any, brain injury qEEG database is used at the neurofeedback clinic. Some clinics do not use the brain injury databases as the FDA has put strict limits on their use. If one can find a qEEG clinic with an MD on staff, there is a greater likelihood of getting a qEEG diagnosis for brain injury.

I'd say a neuropsych exam would be best. From my experience MRI/CT Scan/EEG/ect... Will show something IF it is serious enough. However, you can have a comcussion without it showing on one of those test. A neuro psych and cognitive eval will usually show/prove your concussion symptoms. I say prove because many doctors neruos will recognize your headaches and only that. Your other symptoms will according to many be from depression.

A neuropsych will look at your cognitive symptoms and how you function. In my situation my MRI and CT scan were normal and have been normal for ever concussion I've had (about 6). However I am not normal I have trouble every day cognitively I can't function normally.

My neuro refuses to believe I have had a concussion even tho I have taken the Impact tst 2 times and got an invalid score both times after my last injury and I can't function. He sees only my headaches which I can contain with some advil and tylenol. He says I'm depressed without looking into my life. Before my head injury I was highly functiononing after it I went down hill more and more as the timne passes. Now 11 moths later I'm fed up with it. Are there days I get upset from it yes but am I just depressed or is it that this has gone on so long tht I get so frustrated with it and the dumba** doctors and that's what makes me upset. I am currently wait a neuro psych exam.

The doctors I am to see for it already have no doubt that I am the way I am from concussions just from mt history. They look at things different then a regular doctor they look at your history with tbi and do cognitive testing to see if your symptoms are truely from a tbi. If your struggling with a neuro or gp ry a neuro psych to see if they can "persuade" your neuro to see it diffeently.

There is a big challenge with NeuroPsych Assessments (NPA). Many NeuroPsych doctors (NP) have a bias against prolonged symptoms from a concussion. This causes them to look at NPA results with a bias against concussion as a causation. These biased NP's will make every effort to diagnose depression and anxiety as the cause of the cognitive, memory and other dysfunctions.

I have had 2 full NPA's five years apart and in both, the NP diagnosed depression. They added to this malingering/faking, even though the validity tests showed no malingering. The mis-read of the MMPI-II also supported their diagnosis of depression.

The NPA will usually accurately diagnose cognitive and memory functions. This is valuable to confirm the subjects symptoms. It is just the bias or misinformed diagnosis of cause that makes NPA's problematic.

Mark, If someone has had an NPA prior to TBI would you recommend they get one post TBI? I had one about 3 - 4 yrs ago for an unrelated issue. No depression diagnosis. PTSD and anxiety were diagnosed. Memory and cognition were all high scores. In my case memory and cognition are huge factors right now, but the drs are more focused on the headaches. i am 6 mos post injury and so frustrated that every i walk into the Drs office it seems like they try to put words in my mouth to convince me to say I'm fine and I'm better when I'm not. I'm at a stand still. I am not a good self advocate at all, and even less so now that i have a hard time with word finding and frustrate so easily.

Jennifer

Jennifer,

Welcome to NeuroTalk.

Yes, it would be worthwhile to have another NPA, especially if it duplicated the tests of the previous NPA. Do you have access to the report from the past NPA?

Think of your past NPA as your baseline. Any changes can be assumed to be from your recent injury.

Regarding bookmarking comments you want to show to others. Cut and paste the comments into a Word document or even just MS Wordpad or MS NotePad.

This way you can continue to add to you 'research file' as you find more good information.

I use this system frequently to accumulate information for later review.

Have you checked out the TBI Survival Guide at www.tbiguide.com yet/

There is also a good YouTube video series by John Byler. It is 6 part that take about an hour total. It is at http://www.youtube.com/watch?v=x9Xso...ature=youtu.be

Show it to you family and friends.

Introduce yourself. Tell us how you got hurt. You will find plenty of others in a similar situation.

Are you in rainy Oregon? Humid heat can be tough.

My best to you.