Decline in neuropsych eval performance?
 

Hi,
I had my second neuropsych eval recently (don't have results yet) and it was nearly identical to the test I had the first time. However, I noticed myself struggling more on certain parts of it and not getting as many questions as before because I either couldn't answer or was getting them wrong. I even flipped the minute and hour hands on the clock drawing.

I did have pain, but I had pain last time also. Just wondering if it is unusual to decline so much in performance in the case of post-concussion over a 2 year period where there has been some rehabilitation. Some improvements have been noticed in general as well, but more with overwhelm issues rather than cognitive.

Maybe it is all variable on the day, but thought I'd ask!

A bad night's sleep can make a big difference in an NPA. Plus, there are a myriad of other factors that can have an impact on your performance.

Why did you have another NPA ?

What are the symptoms you are struggling with the most ?

What kind of rehab have you had ?

I don't recall anything unusual about my sleep the night before, but that doesn't mean I typically have great sleep.

I have had on/off PT and OT and one round of speech therapy. Dizziness and constant headache and neck pain (have been through many treatments including 2 ablations - 1 a week before this neuropsych) are the biggest problems.

Then issues include nausea, aphasia, apraxia, being easily confused and overwhelmed, poor attention span, some memory loss, hand weakness/control loss, trouble reading aloud after not too long (and read below average speed), convergence insufficiency. There's probably other stuff.

I have depression and anxiety (also OCD) but they are improving. Had before accident too.

Many with PCS have chronic poor sleep that they think is just normal, not so great sleep. If you wake up with any fogginess, you did not sleep properly. The injured brain needs much better sleep than the healthy brain.

If you have up and down days with no noticeable reason for the down days, sleep is likely the culprit.

What do you do to maintain good neck posture during sleep and rest ?

Depression can also affect NPA performance.

Have you been taught any work-arounds, accommodations or coping skills ?

I don't see you ever explained your injury. Were you in a car wreck with whiplash ?

I had started to wake up more refreshed over the summer, but that changed again in the past month or two. It could be stress, medication, or just my usual up/down.

I don't know what I'm supposed to do for my neck during sleep... I use a firmish latex pillow that feels very comfortable and supportive to me.

There are many workarounds and adaptations I have now and picking up more all the time. Also needing others to do home care, cooking, driving and then using a shower chair, walker, and cane. Just knowing when to take a break is a big thing.

I had a concussion and whiplash in a car accident

The neck posture issue is simple. You want to support your head so your head and neck and spine stay straight. If you sleep on your side, a firm thick pillow helps. If you sleep on your back, a thinner pillow that you can tuck into a ball at each side of your ears so your head stays straight and does not roll to the side can be good. You do not want much head lift if you sleep on your back. That strains C-1 and C-2. Some of us get our best sleep in a cozy recliner.

What was the ablation for ? Where ?

I don't think any of us can answer that here. When you see the results have that conversation with the neuropsychologist.

What were your goals for the second NPA? Was it to check progress?