Nervous about Neuropsych exam - question
 

Hi all

I am going in for Neuropshychological testing on Tuesday as ordered by my neurologist. They said it will take all day. This is also a work. comp. case, so they will be getting the results.

I am nervous because I feel like most of my cognitive skills are in tact, but I get exhausted easily from using my brain and cannot handle a heavy, demanding work load like I used to. I can go about 2 hours, and that is it. I used to work an 8 hour day at a physically and mentally demanding job, then go home and do house/garden work, then do a heavy work out and then cook dinner, etc... I can't last nearly as long now.

So I feel like my skills are still there but my capacity is greatly diminished. Also, my physical symptoms of dizziness, lightheadedness, vision issues, vestibular issues, balance, etc... affect my cognitive abilities.

Will the testing pick up on this? I am worried that if the results come back fine, then work. comp. will try to say that nothing is wrong with me.

thank you for help.

You can stay up late the night before. It will leave your brain so it becomes fatigued quicker. I doubt you will have a problem. The tests do a good job of identifying problems.

The tests also do a very good job of picking up on malingering too so make sure and give it real effort.

There is one test that they give you--it just seems like a simple memory test--that I later learned was really a test of malingering. It is designed to be such that no one should make more than "x" number of mistakes and if you do, then they can consider it an indication of malingering.

I understand your worry; I would bet most of us do! We have all struggled with a deep distrust of doctors making the proper diagnoses.

The important thing, again, is just give it your best. There are so many different tests administered, it helps the evaluator check the results against each other to come to a sound conclusion.

For me, I felt much like you because I knew my intellect was intact. After reading Brainlashed I was afraid that would work against me but still gave it my best...

And because I did, the results were surprising in exactly what the doc picked up on. The testing showed a very superior intellect (uh, that is the official terminology--I promise Im not trying to brag!) but showed impaired attentional skills among other things.

You see, with me it was this big disparity between results of tests of my intellect and tests of my concentration skills that confirmed for the doctors the problem I already saw.

One other piece of advice that others may add to -- but don't "wrap yourself" in your neuropsych eval results once you get the report. First, it isn't guranteed to pick up on all of your problems. Second, it's not a measure of what kind of recovery you can expect. I have continually forgotten both of those things.

From what I have learned about the validity/malingering tests is quite simple. They ask you similar questions and compare the answers. If the answers are different, it can indicate faking or malingering. They also look for consistency in performance.

Unfortunately, the scoring psychologist will write the report based on his biases. I scored 48/50 and 49/50, almost perfect on the no malingering scale. They consider malingering when the score is 37/50 or lower. But, the Ph.D. neuro-psychologist claimed I was faking it because I scored very high in the intelligence scales and very low in the memory and processing speed scales. I also scored low in the depression scales meaning little indication of depression. He claimed I was showing memory and processing speed deficits because I was depressed.

My research showed what Lawyer's NPA said. High intelligence with low scores in other areas are strong signs of an organic injury well after the intelligence was developed and matured.

So, just do your best.

If the report is screwy like mine, a good attorney should be able to help.

btw, A good NPA can be very accurate. I have had two more since my first in 2002. The second in 2007 has almost identical result to the first and the third in 2014 was very similar.

Thank you!! This is all very helpful.