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Estrogen & Memory

NY Memory Services
65 East 76th Street
New York, NY 10021

Tel: (212) 517 6881
[email protected]

What constitutes a good memory evaluation?


A memory evaluation should include an initial consultation, a selected  battery of neurocognitive tests, laboratory testing of blood, MRI and functional brain scans to arrive at a diagnosis. Treatment is optimized through a multi-modal approach.

More information on our diagnostic and treatment staff.

The initial consultation:

This generally consists of an extensive history, general medical, neurological and specialty examination lasting an hour. Following this initial evaluation, a patient may then require no further testing, or may require one or more of the following evaluations:

Neurocognitive testing:

These tests are designed to elicit disturbances in memory and thinking. Just as a cardiac stress test is helpful in diagnosis, treatment and prevention of heart diseases and heart attacks, appropriately administered and properly interpreted neurocognitive tests are invaluable in brain dysfunction. Depending on the symptoms, individual tests are selected to best evaluate each associated brain area.  Testing  lasts about four to five hours.

Laboratory work-up

As part of a diagnostic work-up, in some patients, a laboratory work-up is performed. This work-up eliminates treatable causes of memory disorders. This may include tests for anemia, vitamin levels, thyroid and ovarian hormone levels and tests for chronic infections, such as Lyme. On occasion, tests for auto-immune illnesses, vasculitis, lead and other heavy metal levels, or genetic testing is performed. Genetic testing is a controversial area and should only be approached after the patient and family have been counseled. It is indicated only in a small group of patients. Determining the Apolipoprotein E genotype is necessary in rare situations.

Neuroimaging if needed (MRI, SPECT, PET)

Brain imaging includes both structural (CT scan or MRI scan) and functional imaging (SPECT or PET scan). CT or MRI scans are performed to rule out ‘mini-strokes’ or other structural causes for memory loss. At times, these strokes are ‘silent’, manifesting mainly with memory loss, rather than paralysis or other such difficulties. 

SPECT or PET scans evaluate brain functioning rather than structure. These scans measure blood flow to brain regions or the use of nutrients by areas of the brain. Such scans help pinpoint areas of difficulty when an MRI or CT scan is normal. Other functional imaging techniques include functional MRI. Generally, functional imaging of the brain is not performed routinely, but only in a subset of patients with memory difficulties, where there may be diagnostic difficulties. For the genetic counseling and caregiver support programs, the consultation will be geared to address these issues and will not usually involve testing. Instead information about the affected family member will be needed to answer an individual’s concerns.

Some patients require an electroencephalogram or EEG, an evaluation of brain function by monitoring brain electrical activity, produced by individual nerve cells.

After a diagnosis was made:

Once these tests have been completed, a diagnosis is made and a treatment plan is formulated. The patient (and family, if desired) meets with the physician for an informing visit that is an hour long, going over all results of the testing. The treatment plan is then discussed and finalized in conjunction with the patient and the family.

The treatment plan:

Medications and behavioral treatments for treatment of memory disorders related to menopause, Alzheimer's disease, and other disorders are prescribed as needed. Cognitive rehabilitation, with strengthening of weakened skills (such as language), and strategies for coping with and overcoming deficits in memory are used in others.

If you would like to make an appointment or for further information, you may contact us at 212 517 6881.  Our office hours are Mondays through Thursdays, from 9 AM to 5 PM. 

Please note that all material contained herein is provided for informational purposes only and should not be considered as medical advice or instruction. Consult your health care professional for advice relating to a medical problem or condition. Please also read the disclaimer section.

 

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