A neuropsych evaluation is a detailed examination of a patient’s brain function to provide insight into behavioral and cognitive changes. It involves a series of tests which may last four to eight hours and could be distributed over multiple sessions. The administrator is often a neuropsychiatrist or highly trained technician. At the end of the testing, the doctor can review the information collected and discuss it with the patient as well as other care providers.
Patients may be referred for a neuropsych evaluation for a number of reasons. A common concern is a traumatic brain injury, stroke, or similar example of damage to the brain. Patients with suspected cognitive disabilities might also be referred, along with people who develop cognitive or behavioral changes without a clear cause. Sometimes the evaluation helps with a differential diagnosis, by ruling potential diagnoses in or out. In other cases, it may establish a baseline for future reference in patient treatment.
Another reason to order a neuropsych evaluation is in preparation for a procedure involving the brain. A neurosurgeon might want to determine if a surgery is appropriate, or might request an evaluation to learn more about the patient’s level of function. After the surgery, a series of evaluations can track the patient’s recovery and determine if the surgery was beneficial. In all these cases, the results of the neuropsych evaluation would be shared with the referring physician.
The evaluation involves a series of questions. It starts with a detailed patient history, which should include a review of the patient’s medical records, including prescription information, so the doctor knows about any factors that might have an impact on brain function. For example, a patient’s behavioral changes might be explained by a change of medication. Then, a series of tests can be administered to assess different areas of brain function.
Neuropsychiatrists can use the testing to evaluate reading and writing ability, problem solving, critical thinking, and other areas of brain function. They use standardized tests and compare the results with patients who have a similar demographic profile, like those of the same age and educational background. This can allow them to identify deficits and strengths. A patient might have poor executive functioning which makes it difficult to stay organized and complete tasks, for example. None of the tests are invasive, but they can be time consuming because they require working through large numbers of questions and simple tasks.
At the end of a neuropsych evaluation, the doctor can prepare a detailed report. It discusses the test results and their meanings for the benefit of the reader. Patients and their families may discuss abnormal results and how to proceed with treatment and other options. Other care providers can also review them to develop an appropriate treatment plan and monitor the patient effectively in the long term.