Woman with multiple brain tumors 36 year old LPN Brain tumors at age four, then in teens, then twenties, then early 30s. Now has inoperable tumor. Seizure history: petit-mals from age two, grand mal seizures after meningioma surgery, gelastic epilepsy at age 35. Breast cancer: recent surgery, radiation, chemo. Errors at work: Fit for work?

Woman with multiple brain tumors Borderline Free Recall

Borderline Free Recall

Woman with multiple brain tumors Note that IR and DR are above 82.5%

Slick, Iverson and Sherman (1999) criterion D We must rule out a condition that can fully explain the failure on the PVT. Temporal lobe seizures or petit mal seizures, both frequent in her past, could explain the results. When doing the Wisconsin she claimed the test had frozen. In fact it had not. She had lost track – possible partial complex seizure.

Contrast those results with a 48 year old woman with mild TBI from falling off a mechanical bull in a bar Possible brief LOC GCS 15 in ER No ambulance called. Normal MRI scan of brain. No PTA. No initial treatment for injury. c/o nausea, vertigo and vomiting for many months. 2 years later, complains of inability to work as a hairdresser because of cognitive impairment. “Lost most of my memory”.

There is no neurological disease to explain 70% on DR

No neurological disease to explain failure

No neurological disease to explain failure

Woman with recurrent brain tumors and long seizure history passes MSVT and NV-MSVT and only barely fails WMT. There are very few conditions that can explain failure on these tests (mainly dementia, temporal lobe seizures, severe dyslexia). Probable seizures during testing explain her results. Woman with mild TBI fails all three tests. Mild TBI does not explain failure on these tests. Poor effort is concluded.