What Is Done In The First Application In Adults?
What Is Done In The First Application In Adults?
NPISTANBUL brain Hospital and Üsküdar University Feneryolu and Etiler Health Practice and Research Centers within NPGRUP provide resources to help you and your loved ones to understand and intervene in the disease.
Our basic approach;
- Clarify the diagnosis by conducting a thorough examination and neuropsychological examination first,
- Then make a treatment plan with methods based on measurement,
- It is to apply the treatment by following the evidence of the brain with healthy and adequate procedures.
Correct diagnosis is the first step to planning the correct treatment. A patient who is admitted to our psychiatric outpatient clinic for the first time first passes a psychiatric (and, if necessary, an additional neurological) examination.
Patients admitted to our psychiatric outpatient clinic for the first time (especially those who have received treatment before but have not benefited, those with the treatment-resistant disease) undergo a detailed assessment at the stage of diagnosis.
Neuropsychological examination: If not performed within the last six months in patients over 65 years of age or in people with forgetfulness attention problems, high-level brain functions (planning, attention, concentration, memory .. etc.) tests that serve to measure are applied. For this purpose, computerized tests such as SPM; COG; DAUF; NVLT, or a particular group of tests performed by mutual negotiation techniques are used that correspond to the patient's condition.
Personality profile removal: In necessary cases and in appropriate patients, personality characteristics are examined by conducting tests such as MMPI, Rorschach. It is understood whether the patient has a compulsive personality structure that creates intense anxiety or impaired perception and/or thought and thus leads to impaired brain function in the secondary process. The findings are used in the treatment process.
Cardiovascular Assessment: blood pressure and pulse measurements are performed in each patient. For those 65 years of age and older, those with cardiovascular complaints, those who take drugs that carry cardiac risk, and those who are just starting, electrocardiography (ECG) is necessarily performed.
Neuroimaging: If not performed in the last six months, at least one of the quantitative EEG [QEEG], volumetric cranial MRI examinations is performed to examine in detail whether there is a deterioration in the structure or functioning of the brain. If necessary, pet, SPECT, functional MRI can be performed for further examination. Cranial MRI or computed tomography is performed if it has not been completed within the last six months in those over 65 years of age or with a complaint suggesting mental function/neurological disease. Which imaging technique to use is determined after the neuropsychiatric examination.
Sleep Laboratory: In patients with suspected sleep disorders or epilepsy, polysomnography, which is thought to help diagnose, can be performed all night with 12/24 hours of video monitoring EEG. The patient's sleep profile is extracted and its relationship sleep Laboratory: in patients with suspected sleep disorders or epilepsy, polysomnography, which is thought to help diagnose, can be performed all night with 12/24 hours of video monitoring EEG. The patient's sleep profile is extracted, and its relationship with the psychiatric/ neurological table is investigated.
Norobiyokimyasal rating: Patients over the age of 65 in the last six months and is carried out at a younger age is not deemed necessary; may affect brain function by blood and urine analysis which vitamins, minerals, iron levels in the blood (anemia), blood sugar irregularities, liver and kidney functions; a joint or affect the brain and is caused by the presence of infection.
Neuroinflammatory assessment: If it has not been performed in the last six months in patients over 65 years of age and is considered necessary at a younger age; ASO, CRP ...etc in the body, such as rheumatism, tests (blood, urine) are performed that show the presence of a disease that affects the immune system and brain functions along with it.
Neuroendocrine evaluation: Patient's complaints (ex. Weight change, energy reduction, palpitations, tremors, memory-attention problems ...for certain diseases, if it is suspicious-if weight measurement is performed, the levels of hormones that accompany psychiatric tables such as thyroid, cortisol, prolactin and affect brain function are necessarily looked at.
Toxic screening: In people with drug or addictive substance use that affects brain function, these substances are investigated in the blood/ urine. It is repeated regularly at the beginning of treatment and during follow-up.
Clinical pharmacogenetic assessment: In patients taking drugs, drug blood levels rise above treatment values, or drug interactions can lead to impaired brain function. To detect this, blood levels (Monitoring Therapeutic levels) of the drugs used are measured.with, and the psychiatric/ neurological table is investigated