Traumatic Brain Injury and Post Concussion Syndrome For traumatic brain injury (TBI) and post concussion syndrome (PCS).


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Old 02-13-2013, 02:30 PM #1
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Default Has anyone had a neuropsychiatric evaluation?

I was just wondering what to expect from this. I have an appointment on feb 25th. I don't know how I will even make it through six hours of questioning/ testing. My attention span is negative 100,000. any advise comments would be helpful. I need this to prove disability so I can get on Ssdi and ssi. Please keep me in your prayers as I do all of you guys everyday. Thanks for all your support. Brain patch.
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Old 02-13-2013, 03:40 PM #2
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It sounds like you are set for a Neuro Psychological Assessment. These are very common when trying to measure the functions of brain injured individuals.

As you said, you think you will fail miserably at this. That is the whole point. Failure is a good result if the failure is validated by the validity tests.

This is not a face to face test. Most of the tests are short and have a narrow focus, like tapping your finger as fast as you can for 3 minutes. Trying to memorize information. Trying to re-order information, spell or count backwards. Do a pencil and paper tracing test. Assemble a unique set of blocks. You will be observed more than questioned.

Who has ordered this assessment?

SSDI does not usually require a full NPA. In fact, they have psych's who will do an abbreviated assessment of an hour or so.

It has not bearing on SSI. That is needs based.

Do you have an SSDI attorney/advocate ?

I have had 2 full NPA's 3 to 4 hour, and one abbreviated 1 hour, NPA.

So, relax, if you don't sleep well the night before, that is OK. It will only help.

My best to you.
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Old 02-13-2013, 04:16 PM #3
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I've had two, one was an abbreviated (~ 2hours) and the other was a half day.

The exact tests vary depending on how the symptoms present. My deficits included visuospatial and verbal learning and memory, abstract reasoning, mental flexibility, and problem solving. The exam should be conducted by a licensed clinical neuropsychologist.

The evaluation typically starts with an interview to get your self-assessment, and they also observe language, motor skills, and overall affect. They may include a spouse or significant other in the interview (my wife attended this part with me).

They then perform a battery of different tests of cognitive functioning. Again, the exact test may vary based on your areas of difficulty, my tests included:

Subtests of the Wechsler Adult Intelligence Scale (WAIS-IV)
Beck Depression and Anxiety inventories
Reading tests (WRAT-3)
Auditory Learning
Visuospatial memory tests
Trail marking A & B
Wisconsin Card Sorting test
Verbal Fluency

They will compare the results with “normal” scores based on your age, education background and other demographic factors.

I was coming from a different place in that I desperately wanted to go back to work. But overall my advice would be do what you can do, and let them compile the results. If you are having attention/memory issues that will become apparent. On my first one I “failed” miserably, so they prescribed specific speech and occupational therapies which helped immensely, and I was given a “Return to work” recommendation after the second one three months later.

Best to you.
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What Happened: On November 29, 2010, I was walking across the street and was hit by a light rail commuter train. Result was a severe traumatic brain injury and multiple fractures (skull, pelvis, ribs). Total hospital stay was two months, one in ICU followed by an additional month in neuro-rehab. Upon hospital discharge, neurological testing revealed deficits in short term memory, executive functioning, and spatial recognition.

Today: Neuropsychological examination five months post-accident indicated a return to normal cognitive functioning, and I returned to work approximately 6 months after the accident. I am grateful to be alive and am looking forward to enjoying the rest of my life.
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Old 02-13-2013, 04:51 PM #4
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Default Neuropsychiatric evaluation

Mark in Idaho,
I applied for disability with a lawyer and went to the alj level and was denied. I applied with chronic pain in neck, head, back and down my left leg, I had acute liver and kidney failure from an accidental overdose of acetaminophen. Liver dysfunction, degenerative disc disease with bulging disc hitting nerve root, hernia , chronic migraines and hypoglycemia. I had numerous episodes with the hypoglycemia where I passed out and hit head on concrete, PTSD and anxiety/panic disorder.
Social security says I have not seen enough doctors/ specialists for how bad I am claiming problems are.
So I went to a neurologist and he diagnosed me with Post concussive syndrome manifested by cognitive impairment, chronic pain and fatigue. Also, REM sleep behavior disorder, nocturnal frontal lobe epilepsy (did not know I was having this until I got woke up and was having a seizure) chronic migraine with nausea/vertigo and episodes of syncope that may be vasovagal in nature. The neurologist said that a neuropsychiatric evaluation would be helpful in documenting level of disability for the purposes of disability application. That is why I am going for the neuropsych evaluation. I did not realize all these other problems were from hitting my head I thought it was because of having pain all the time. In 2006 I was hit on the freeway and was knocked out. After this accident the chronic pain started as well as problems with dressing myself, having trouble putting outfits together, using toothbrush, hairbrush, blow dryer, fork, forgetting how to cook, forgetting if i paid bills, forgetting if i had taken medication etc. not being able to do normal things. Work was so embarrassing. Ihad slurred speech a lot, did not act appropriately, could not remember faces, names and other things. My employer and clients thought I was drunk or on drugs. I cannot go back to a work environment. Besides the fact that I could not show up or do the job. People make fun of me. They do not understand that I am injured. I pass out in public. I am afraid to leave my house.it is noticeable to others. I hope this will get me on disability. I truly need it.
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Old 02-13-2013, 07:33 PM #5
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Don't stress over the test. The hardest thing will be just putting the time in to take it. Plan accordingly, rest after and try to not stress before. None of what they ask you to do is as important as what they observe. Give everything your best go, be truthful and open.

When I took mine it was at times frustrating but both the neuro-pschologists and his assistant were great. I came away thinking I had scored in the normal range for everything. Results ended up showing pre injury I was very high average IQ. There was a lot that was OK but I had three major deficits. Attention, concentration and processing speed. Last one was a dozy as I scored in the 2 percentile range.

It explained a lot and was validating to learn.
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To see the divine in the moment.
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Old 02-14-2013, 12:30 AM #6
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It is not like a school test. Don't worry. I did mine in one hour chunks every few days, because that was all I could tolerate. Some of the tests are even fun....if you likepuzzles! It will help you understand your brain a bit more.
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What happened: Legs pulled forward by a parent's hockey stick while resting at the side of the rink at a family skate....sent me straight back. I hit the back of my head (with helmet) on the ice, bounced a few times, unconscious for a few minutes. September 11, 2011. Off work since then…I work part-time at home when I can. It has been hell but slowly feeling better (when I am alone☺).

Current symptoms: Vision problems (but 20/20 in each eye alone!) – convergence insufficiency – horizontal and vertical (heterophoria), problems with tracking and saccades, peripheral vision problems, eyes see different colour tints; tinnitus 24/7 both ears; hyperacusis (noise filter gone!), labyrinthian (inner ear) concussion, vestibular dysfunction (dizzy, bedspins, need to look down when walking); partial loss of sense of smell; electric shocks through head when doing too much; headaches; emotional lability; memory blanks; difficulty concentrating. I still can’t go into busy, noisy places. Fatigue. Executive functioning was affected – multi-tasking, planning, motivation. Slight aphasia. Shooting pain up neck and limited mobility at neck. Otherwise lucky!

Current treatments: Vestibular therapy, Vision therapy, amantadine (100 mg a day), acupuncture and physiotherapy for neck, slow return to exercise, magnesium, resveratrol, omega 3 fish oils, vitamins D, B and multi. Optimism and perserverance.
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Old 02-14-2013, 01:22 AM #7
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Brain patch,

It sounds like your attorney may have used the wrong disabilities as your primary disability. The mental health qualifiers in the Blue Book sound appropriate for you. The NPA will help demonstrate your mental condition. It is a NeuroPsychological Assessment not NeuroPsychiatric. Easy error, especially with a brain injury.

You may benefit from an follow up assessment by a vocational/occupational psychologist. SSA brought a occupational psychologist to my alj hearing and he read the NPA and labeled me as incompatible with a work environment. My lack of visual and audio memory functions were not considered even though we thought they would be the strongest qualifiers.

I was denied twice before getting approved at almost 3 years from my first application. One week shy of 3 years.

My attorney knew to let the pros and judge control the testimony. She just was ready with data and simple comments. She made a fortune ($5400 ) for saying almost nothing.

Have you been through your states Vocational Rehab Assessment ? This can determine that the state does not have a occupation that fits your remaining skills.

It sounds like you may run into the same problem I have. My reduced income as I tried to keep working caused my final monthly benefit to be substantially less. Your attorney has his work cut out to date your disability back adequately.

As others said, relax, let the tests speak for you.

My best to you.
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Old 02-14-2013, 10:58 AM #8
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Default Did amantadine help?

Quote:
Originally Posted by Mokey View Post
It is not like a school test. Don't worry. I did mine in one hour chunks every few days, because that was all I could tolerate. Some of the tests are even fun....if you likepuzzles! It will help you understand your brain a bit more.
Mokey,
Did amantadine help? The neurologist recommended this to my pain dr. (primary doctor) in high levels. He says titrated to 400mg per day. That sounds scary to me. What side effects do you have from that? Thanks a lot.
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Had MVA in 2006 resulting in post concussive syndrome manifested by cognitive impairment, chronic pain/ fatigue. Chronic pain of head, neck, back, left leg.
Other problems include REM sleep behavior disorder, nocturnal frontal lobe epilepsy, chronic migraines associated with nausea/vertigo, episodes of passing out, hypoglycemia, liver dysfunction (had accidental overdose of acetaminophen in 2009) had liver and kidney failure, hernia, degenerative disc disease with compression of nerve root, PTSD, and other problems associated with functioning problems from traumatic brain injury (light, sound sensitive, easily overloaded, easily distracted, cannot focus, anxiety problems etc.)
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Old 02-14-2013, 05:19 PM #9
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Default Hi Brian

Yes, it is very common to have this kind of evaluation and it is OK no matter how you do on it. I had one when applying for SSD. My attention span wasn't so hot either, nor could I repete 10 minutes later a list of items. It is OK to be just who you are, in what ever condition you are. Try not to get upset, and just relax a bit when you go there. Most of the people who administer these tests are kind and compassionate. I will keep you in my thoughts and prayers. ginnie
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Old 02-14-2013, 07:08 PM #10
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Brain,

What symptoms is the amantadine being prescribed for ?
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