Physicians and Other Consultants: Part II

Neurologist

The neurological examination should be thorough and performed by a neurologist with in-depth knowledge of MTBI.

In most situations, the neurologist refers the person to a qualified neuropsychologist for a complete battery of tests.

Recommendations from the neurologist and neuropsychologist will most likely lead to a referral for additional assessments and treatment by neurorehabilitation specialists.

The neurologist may prescribe medications and monitor the case.

Neuropsychologist

The neuropsychologist has access to multiple test instruments to assess executive functions, memory, cognition, intelligence, comprehension, perception, language, concept formation, and motor performance. Some of the following tests are often used in the neuropsychological evaluation battery.

Cognition, intelligence, attention and speed of information processing:

• Wechsler Adult Intelligence Scale-revised. (WAIS-R)
• Wechsler Memory Scale (WMS)
• Peabody Picture Vocabulary Test (PPVT) for intelligence
• Wide Range Achievement Test (WRAT)
• Memory and Learning
• Verbal Learning/Delayed Recall
• Visual Learning/Delayed Recall
• Paced Auditory Serial Addition Task (PASAT)
• Boston Naming
• California Verbal Learning Test (CVLT)
• Rey Complex Figure
• Rey Auditory Verbal Learning
• Benton Visual Memory

Attention and orientation skills:

• Digits
• Trails A and B
• Letter Cancellation
• WMS attention/concentration
• Digit Symbol
• Tactual Performance Test (TPT)
• Choice Reaction Time
• Ruff-Light Trail
• Attention to Task and Divided Attention

Verbal and language skills:

• WAIS-R
• Token Test
• Word Fluency
• Construction
• Parquetry Block design
• WAIS-R Block design
• Object Assembly
• Rey Complex Figure Copy

Concept formation and reasoning abilities:

• WAIS-R Similarities
• WAIS-R Picture Arrangement
• WAIS-R Picture Completion
• WAIS-R arithmetic
• Raven's Progressive Matrices
• Categories Booklet Test
• Wisconsin Card Sorting (WCS)

Executive functions and motor performance:

• Halstead-Reitan Finger Tapping
• Grooved Pegboard
• Grip strength
• Impairment index

Ruling out malingering or amplification of symptoms is evaluated by a forced-choice recognition memory test: the Portland Digit Recognition Test. The Hiscock Forced Choice test is another choice.

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