Neuropsych Assessment: Sh*t is getting real

 A few weeks ago I had to go back to the Epilepsy clinic for a neuropsych assessment. You've heard about those cognitive tests that Trump says he aced? Like that, but for SIX HOURS. It was exhausting. Exercise after exercise after exercise, with just a short break for lunch. 

The purpose was twofold:

1 - They wanted to continue to establish whether my language function is on the left or right. 

2 - They wanted to establish a baseline for future testing.

As I've mentioned previously, the left/right thing is more complicated since I'm left-handed, so they have to be cautious. My seizure unit results indicated that my language is likely on my left: "The patient was able to speak fluently and understand language through the right temporal seizures and did not have post-ictal aphasia, suggesting that although she is left handed she is likely left hemisphere dominant for language."

The neuropsyh assessment agreed with this--adding to the case for left-side language dominance. This is good news as far as potential surgery goes... it means that if they cut out a chunk of my right temporal lobe, it should (hopefully) not impact my language ability. 

The rest is more complex. We talked about a variety of things in the follow-up meeting yesterday, but the bottom line is basically that there are some areas of my memory being directly impacted by the seizures (like my visual working memory) which would hopefully be improved by surgery. But there are also areas that are being *indirectly* impacted, which *might* improve if I can achieve seizure freedom (visual and verbal memory). 

"Results of this neuropsychological evaluation showed that Ms. V is likely to have language functions primarily supported by the left side of her brain. Below expectations performance in visual working memory in contrast to strong verbal working memory is consistent with mild dysfunction on the right side of her brain. This finding in also congruent with right anterior temporal lobe seizure focus identified on other investigations. Although her visual and verbal memory were within the normal range, they were somewhat lower than expected given her estimated baseline and are consistent with her self-reported memory changes. This may suggest mild inefficiency in memory functioning."

"In light of right temporal seizure focus on the investigations to date, if a standard right temporal lobe surgery is recommended, Ms. V may experience some visual memory decline, but the risk of global amnesia is low. With seizure-freedom, she may experience improvement in her overall cognitive functioning (e.g., verbal memory)."

I really felt throughout this meeting as though she was trying to sell me on the surgery. Not pressuring, but... trying to sell me on it. 

Also she indicated that I might not get an fMRI now after all (that will be up to my epileptologist though). If they are confident in the left/right language thing, they will not need the fMRI.

The next step is for their whole team to convene to discuss my case. This will include my epileptologist plus the one(s) from the hospital who were there for my inpatient stay, plus the psychiatrist, the neurosurgeon, the MRI and EEG techs who did my hospital tests, and anyone else they deem necessary. They will look at ALLLLL of my data and decide what the best course of action is, and then bring it to me. 

And in case I haven't been clear: Surgery = cutting out a huge chunk of my temporal lobe, amygdala, hippocampus... (who knows how much, they haven't decided yet!).

TLDR: I have done nothing but eat comfort food and panic since the meeting yesterday.