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Clinical Evaluations

Specialties: Neuropsychiatry, Behavioral Neurology & Psychopharmacology

This includes head injury, seizures, movement disorders, brain problems, headaches and attention deficit disorder, particularly when linked with psychiatric or behavioral difficulties. It also includes related forensic evaluations.

Focus:

The focus of the Pacific Neuropsychiatric Institute is extensive face to face clinical evaluations for patients with neuropsychiatric and psychopharmacologic difficulties.

Referrals:

Patients are generally referred from other physicians (including universities, plus private neurology, psychiatry, internal medicine and primary care). A referring and follow-up primary care physician is essential. Patients are triaged for suitability (e.g. symptoms, motivation, availability to attend on many occasions during the day, insurance, support physicians, children aged =8 and adults, literate). Outpatients are from metropolitan Seattle, other WA state areas, Pacific NW, elsewhere in the USA, or beyond. Special arrangements may be made when patients come from outside the Pacific Northwest.

Type of Evaluation:

If accepted, patients undergo a model, comprehensive neuropsychiatric and/or psychopharmacologic evaluation (e.g. eight lengthy, complex clinical consultations by Dr Neppe, plus extensive neuropsychiatric testing, plus possible ambulatory electroencephalography, culminating in a ~100 typed page report to the physician and referral back when appropriate.

The major approach is towards pharmacologic management of the pathophysiologic difficulties (not psychotherapy) although the PNI tries to be very aware of the relevance of the biopsychofamiliosociocultural perspective. The evaluation goal is to provide a blueprint not only for the present but directions for the patient's primary physician (generally necessary) to manage the patient in the future. Vernon M Neppe MD, PhD, as the Director of the Pacific Neuropsychiatric Institute (PNI), comprehensively evaluates all new patient referrals.

Conditions:

Patients may have either complex or simple problems, with any neurological conditions like seizures, spells, headaches, movement disorders, head injury, brain malfunctions, attention deficit disorder, dementia, tardive dyskinesia, blackouts, unusual episodes, atypical spells, Parkinson's disease, narcolepsy or sleep problems, who require detailed assessment for behavioral or psychological, emotional or thinking difficulties. Also included are patients with subjective paranormal / psychic experience, irritability, pain, chronic fatigue, unusual brain linked endocrine disorder and any organic mental disorder. The patient spectrum therefore reflects combination neurology/medicine with psychiatry, including refractory depression, non-responsive psychosis, depression and panic, and medication problems.

Evaluation Details:

Patients generally complete detailed questionnaires on computers or paper, plus tests given face to face and other tests like EEGs, ambulatory EEGs, MRIs or blood tests over many half day sessions. Psychosocial screening, personality, behavioral and psychodiagnostic evaluations, special evaluations of areas of the brain such as the temporal lobe or for specific neuropsychiatric abilities and deficits occur. Referrals to follow-up physicians may occur after weeks or longer depending on circumstances.

Providers:

The PNI and Dr Neppe are preferred providers for patients with various insurances such as parts of Premera Blue Cross and Regence Blue Shield and Uniform Medical Plan, but also consult for a diverse range of other insurances. We do not evaluate Medicare, DSHS, or L and I patients. We evaluate medicolegal patients, and we accept PIP insurance.

Internet Consultation:

The PNI cannot do any specific consultations over the internet and any EMails or other communications in that regard will necessarily not be answered. However, Pacific Neuropsychiatric Institute may have the most comprehensive site on the web, and you may read about Dr Neppe?s books on BrainVoyage.com.

 

 


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