A neuropsychological evaluation is a series of tests that evaluate how a patient is doing in mental and physical aspects of life like:

intelligence, executive functions (such as planning, abstraction, conceptualization), attention, memory, language, perception, sensorimotor functions, motivation, mood state and emotion, quality of life, and personality styles – med.unc.edu

For me, it was a pretty generalized test to evaluate how I am doing after having epilepsy for three plus years. Having seizures can damage the brain, and in my case having unsuccessfully treated epilepsy has done some damage. But, before I get to my results let me explain what this experience is like.

I have to say this was unlike any other test I have gone through. Honestly, I would rather have traded this experience for 5 more EEGs. I have nothing against this type of test, it was very informative and the psychologists were very nice and helpful. I just wish I had done one of these years ago so I could have established my own baseline. But, it was exhausting and frustrating. That’s the nature of the test.

I had to schedule this 3 months in advance and completely forgot that I had to go until they emailed me a few days prior. They are busy, and it was no exception when I was in their waiting rooms. I saw so many different people from all walks of life from the moment I walked in. It was very different from my neurologists’ waiting room.

Starting with the paperwork, they have you sign a waiver saying they are not responsible for any stress they may put on you. I, of course, signed it because at that point I was just curious. And then it goes on to say things about how this is their job, you signed up for this and your doctor agrees that this is whats best. All to make sure you understand that they have to do this.

After that, I was given a pretty standard questionnaire. The moment you get that questionnaire they are watching you, and they read your answers right away once they sit you down for the first part. Which is answering questions about where you are in life, how you handle certain situations, if you feel like your quality of life has gone down etc. They range from “I have trouble doing the dishes” to “I find it difficult to do everyday tasks that require me to walk”. I would say there were approximately 20-30 of those to answer on a scale of 1-4; 1 being “not at all” to 4 being “a lot”. They want to know the specific areas of your life that are no longer what they used to be due to your illness.

For me my areas of struggle were short-term memory issues, doing the dishes without breaking them, dropping things more than normal, holding a proper job because of the effect stress has on my overall health, handling stress, sleep/insomnia which leads to oversleeping.

After the questions with the two psychologists, one left the room and the writing portion started. This is where things go pretty fast so I will try to detail as much as I remember, but I will probably forget a few things that happened. I just want you guys to get the overall gist of it so that you feel more prepared if you have to get one of these done. They did not tell me what we would be doing or how long it would take. The one detail they did tell me was that my results would be compared to a baseline of people my gender, age, and educational background in order to see where I am lacking.

The writing was quick, and now that I look back I think it was more memory than writing. What I was required to do was memorize the paper she held up for 10 seconds with shapes on it. After that, I had to draw them from memory in order, as accurately as possible. So, we did that for a bit. It took me a few times to get it down but after the 3-4th time looking at it for 10 seconds at a time I got it down.

Then, we moved on to my worst nightmare. She read off a list of approximately 20 words, once. I had to repeat them back to her. And it kept going and going and going.  I could probably get a few, my average was remember around 4-5 words off that list of 20. It was repeated a total of 5 times. And then between this 4th and 5th time she read off of a different list that was longer and I barely got through that one. After that, she asked me to go back to the previous list and remember as many of those. I struggled the most with this one. I definitely felt myself getting frustrated, but I reigned in the anger and just let it happen.

Finally, the word part was over. Now we did a pattern/numbers/counting (I have no idea what to call most of these) type of test, she would show a paper with a bunch of dots on it and I had to count them and say how many were on the paper. Luckily, they were arranged in patterns for the most part which made it easy and went by fast. Then, the finger tap test happened.

By finger tapping I mean there was a clipboard with a little trigger and a counter next to it. With my index fingers on both hands (we switched back and forth from right to the left) I had to tap it as many times as I could within 30 seconds. That went on for a few minutes and was as annoying as you would think. Which I think might be part of the point of that test. Everything is meant to test your limits physically, mentally and emotionally.

After that, I was moved into another room with the other psychologist. This room was weird, there was a desk, two chairs and some things on the desk that only pertained to the tests. Other than that, not a single poster, decoration or window. This room was so blank and uncomfortable it really got to me after a bit.

This room is where the remainder of the tests were held. They had a lot to do with visual tasks and numbers with some auditory/speaking sprinkled in. One test required me to place a set of 9 small blocks in a pattern that was shown as an example on a paper. That went on for a bit, just copying what was shown. Then we moved onto visual puzzle questions. A shape like a rectangle or a circle would be shown at the top and 6 options of the partial shape placed below. From those 6 options you had to choose 3 to make up the shape above, not 2, not 4, but 3. That went on until we completed about 10 that were in a book.  I felt that I did decently on that one.

From there it was back to listening and repeating. I was read two stories total, and after each story, I had to relay what information I remembered as best I could and as accurately as possible including trying to match the vernacular. So, like with the list of words, in the beginning, I was awful at this. I could not remember the name of the person in the story, let along the things they did. I got maybe half, at best, correct but I definitely did not get the vernacular or the order. I remembered some details, but they were jumbled, hazy, slightly off and not in the correct order.

Then came the list of weird words. All I had to do was read off a list of over 50 words, they wanted to see if I could not only pronounce common words properly but uncommon ones as well. He wanted to see if it was difficult or hard for me. Long story short, it was easy for me. Then he took a detour and made me go back to the first test with the shapes and draw them from memory again. After that, we moved on to trivia which I don’t know if it was officially called that because they give you no explanation of why or what it is you’ll be doing. He asked a bunch of questions like “Who was MLK?”, “Who was Sacagawea?” , “When was the Civil War?” etc. So, I would answer and then he would ask me to elaborate on that in order to see how much I could recall that one topic/person.

We ended with a computer “game”, again no explanation on how it works so as you go you figure out the rules which change every so often. It was four cards, each had a symbol, color, and shape on them all different from each other. At the bottom was a card and you dragged it to the corresponding card. The card it matched with would change every four turns. The yellow would match the yellow or the star with the star (regardless of color), if it had 4 symbols on it you would match it with the one with four symbols. You’d keep going with the rule until the computer changes it and tells you-you’re wrong until you figure it out again. It went on for about 10 minutes.

Finally, it was over, it took three hours total from start to finish. I may have missed some of the little tests and details, but these were the main ones I can remember because there were so many. I do remember during some of the tests they would tap their fingers on the desk or fiddle with a pen, which I immediately thought was straight up fake AF. It didn’t bother me because I knew it was just to see if they could provoke a reaction during a difficult test. I just focused on answering the questions and nothing else because I hate failing tests.

When it was all over I spoke with the both of them again and they explained my results, along with suggestions to help. My results were that overall I was normal in many categories. I have awesome random memory recall and should be on Jeopardy, their words not mine. Where I struggled was auditory processing, which is associated with the left temporal lobe. When I said I did badly on the word and story tests, I meant it, I was awful. They told me that it’s a problem that shows the damage done by 3+ years of having partial seizures in my left temporal lobe.

They confirmed that I was in fact not driving. Along with that asked what I do when I attend classes or listen to lectures, and anything school related. I told them I’ve been lucky and most of my classes have corresponding written notes to reference. But, I do recall struggling in classes I attended in person on a regular basis with sparse notes. You know the professors that expect you to hang on every word they say? Then you have to get permission to record them or ask for notes from someone else. Those professors were just awful, and now I know why I would do so badly in their class compared to others.  The damage in my left temporal lobe prevented me from fully absorbing what was being said along with blanking out for a few seconds at a time and becoming disoriented as a result.

They told me that if I have a class like that again to go through the DRC for help. I can obtain transcripts from courses through them. I find this irritating, it should always be an option for every student no matter what. If you’re a teacher and you are required to do this anyway, make it a resource for everyone, not just on request. Don’t be rude. Not every student is going to be able to listen and remember every little detail, let alone be able to write everything you say.

That being said, I’ve had lazy teachers who are fantastic and always had interesting and engaging lectures. They just didn’t have time to make the slides or a TA who was not helpful. There are good teachers who only lecture. Unfortunately, we all can’t learn exactly the same and people like myself wind up struggling in simplest of classes. I can’t help my issue, the damage is done. All I that can do now it work on prevention.

That was my experience with a neuropsychological evaluation. It was interesting, irritating and helpful. I feel like this should be something that normal people do going into adulthood. They can help you with how to study, be a better student and see if there is something wrong and hopefully catch it early. To me, it was a mixed bag of conflicting feelings hearing these results. I was upset at what it meant but relieved that it’s something they are taking notice of, I’m not crazy or losing my mind.

Let me know if you’ve gone through this before, and what was it like for you? What were your results?