Patients who are chronically amnesic are those who can not meet
the criteria of the Westmead PTA Scale for a period of
12 months after emerging from coma. They are patients who are
eligible to use the Westmead PTA Scale, however their injury
is so severe that they can not cope with the demands of the scale.
In our experience it is advisable to persevere with PTA testing
for as long as possible. We believe it is not unreasonable to
ask that the PTA examiner continue to test a patient for 3 months
on the scale when they find that the patient's score has reached
a plateau. At this time the Clinical Neuropsychologist needs to
analyse the patients poor performance and rule out any other alternate
explanations. It is also advisable to give the patient a break
from testing for a period of 2 - 4 weeks. If possible repeated
attempts should be made to reach the Westmead PTA Scale's
criteria for a year after emergence from coma. If no change has
occurred then the patient's memory functioning needs to be reviewed
annually for the rest of their life.
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