Which of the following is true about the following EEG?
- A.
It suggests a seizure focus in the left inferior parietal region
- B.
It is consistent with the previous brain surgery
- C.
It is indicative of encephalopathy
- D.
It shows triphasic waves
- E.
C & D
Which of the following are among the 3 most common causes of SE in children?
- A.
Change in antiepileptic drug treatment, administration, or compliance
- B.
Congenital abnormalities
- C.
Tumor
- D.
CNS infection
- E.
None of the above
Clinical features of mesial temporal lobe epilepsy include all except:
- A.
Early age of onset
- B.
History of complex febrile seizures
- C.
Stuttering course of seizure control
- D.
Clonic movements
- E.
Hippocampal atrophy
All of the following are true about initial investigation into patient with seizure in ER except:
- A.
CK levels obtained between 6 and 12-h post-event show elevated levels in convulsive seizures and not in PNES
- B.
Prolactin level should be drawn within 20 min of event to differentiate organic event with the loss of consciousness with PNES
- C.
Lactic acid levels drawn soon after an episode will show elevated levels after convulsive seizure
- D.
Repeat EEG should be performed in patients with alcohol withdrawal seizures and EEG showing generalized spike-and-waves
- E.
All of the above are true
Which of the following is true about recurrence of febrile seizures?
- A.
Phenytoin is effective in preventing recurrences.
- B.
The risk of recurrence is increased if the temperature was high at the time of the seizure.
- C.
The older the age, the more likely the febrile seizure is to recur.
- D.
Complex febrile seizures are more likely to recur than simple febrile seizures.
- E.
Frequency of febrile illness is directly correlated with recurrence risk.
During carotid endarterectomy, intraoperative EEG monitoring can help avoid:
- A.
Seizures
- B.
Carotid clamping
- C.
Hypotension
- D.
Shunting
- E.
EEG is useless
In treatment of refractory status epilepticus all of the following statements are true except:
- A.
Continuous propofol infusion of >50 mcg/kg/min is associated with a risk of hypotension
- B.
Hypothermia may be used as adjunctive treatment
- C.
Levetiracetam dose used should not be less than 2000 mg/day
- D.
Mortality rate is higher with i.v. midazolam than with i.v. propofol
- E.
Lacosamide may be effective adjunctive treatment
Seizures with generalized onset are seen in which of the following genetic epilepsies?
- A.
Benign childhood epilepsy with centrotemporal spikes
- B.
Autosomal dominant nocturnal frontal lobe epilepsy
- C.
Temporal lobe epilepsy with auditory features
- D.
Dravet syndrome
- E.
None of the above
Among the following factors, the one that is associated with the most favorable outcome in SE is:
- A.
Early treatment initiation
- B.
Non-compliance with anticonvulsant medications in patients with established epilepsy
- C.
Epilepsy onset in the elderly
- D.
Early arrival in the hospital
- E.
None of the above
Which of the following is false about idiopathic generalized epilepsy (IGE)?
- A.
Family history of epilepsy is often present
- B.
Motor seizures have a tendency to occur upon awakening
- C.
Photosensitivity seen in ~5% of patients
- D.
EEG background is often abnormal
- E.
Family history of febrile seizures can be positive
Which of the following statements is true about slow spike-and-wave complexes?
- A.
They have a frequency that is faster than that of absence epilepsy
- B.
Seen in Lennox–Gastaut syndrome
- C.
Are deactivated by sleep
- D.
Are associated with normal posterior basic rhythm
- E.
None of the above
A 5-year-old girl is seen in the first seizure clinic after a nocturnal episode of vomiting, pallor, behavioral irritability, and then eye deviation to the right and unresponsiveness, followed by a generalized tonic clonic seizure. The total duration of the episode was 5 min. Her development has been normal, and there is no family history of seizures. Which of the following is true?
- A.
This epilepsy syndrome has a poor prognosis for seizure control.
- B.
Treatment typically includes corticosteroids and vigabatrin.
- C.
Most patients with this disorder have major structural brain malformations.
- D.
Trauma is a frequent antecedent of this epilepsy syndrome.
- E.
The EEG likely will show paroxysms of occipital spikes.
Which of the following is not true about atonic seizures:
- A.
Slow waves correspond to atonia
- B.
Loss of muscle tone lasts <100 ms
- C.
Ictal EEG can consist of generalized polyspike-and-wave activity
- D.
Ictal EEG may consist of low-voltage fast activity
- E.
All of the above are true
Which of the following statements is not true about ictal EEG?
- A.
It is marked by monomorphic features
- B.
It is often not seen in association with seizures that do not cause alteration of awareness
- C.
When seen on the EEG before clinical seizure onset, it tends to be of more localizing value to the epileptogenic zone
- D.
When onset is characterized by high-frequency activity, it indicates proximity of the recording electrodes to the epileptogenic zone
- E.
None of the above
Which of the following statements is true about EEG in generalized epilepsies?
- A.
In absence epilepsy, the ictal discharge has an abrupt onset and termination
- B.
In juvenile myoclonic epilepsy (JME), polyspike-and-slow-wave discharges are seen at a frequency of around 5–6 Hz
- C.
Tonic seizures are often associated with voltage attenuation
- D.
Tonic–clonic seizures may start with 10 Hz activity that gradually increases in voltage
- E.
All of the above are true
A 6-month-old female is referred by a gastroenterology colleague for episodes of trunk flexion that occur in clusters four times per day. This has been occurring for the last 3 days. There have been some concerns about her vision, and her head control is poor. Which of the following is true?
- A.
She has gastroesophageal reflux and should be referred back to her gastroenterologist
- B.
She has an exaggerated startle reflex and should be referred back to her pediatrician for routine care and developmental follow-up
- C.
She has one of the benign epilepsy syndromes of infancy and, after an EEG, should be followed routinely in 3 months in your clinic
- D.
She has a malignant epilepsy syndrome of infancy and should have an EEG, MRI, and further genetic and/or metabolic workup, depending on the initial findings
- E.
She likely has seizures originating from the left temporal region and, after an EEG, should be started on levetiracetam
Which of the following statements is not true about epileptiform discharges?
- A.
Anterior temporal spikes have higher association with seizures than occipital spikes
- B.
Spikes can be seen in non-epileptic conditions, such as congenital blindness
- C.
Multifocal spikes are commonly associated with a slow EEG background
- D.
Multifocal spikes tend to be associated with cognitive but not motor deficits
- E.
In BECTS (Benign Epilepsy with Centrotemporal Spikes), the positive end of the dipole is in the frontal regions
Recognized pathophysiological mechanisms of pharmacoresistance in refractory status epilepticus include:
- A.
Failure of presynaptic synthesis of GABA
- B.
Failure of release of GABA from pre-synaptic vesicles
- C.
Failure of synaptic glutamate transport mechanism
- D.
Internalization and destruction of synaptic GABA-A receptors
- E.
None of the above
On day of life 3, you are consulted by the neonatal intensive care unit about an infant who has recurrent tonic spasms in clusters. The EEG shows a suppression-burst pattern. Which of the following is true about this epilepsy syndrome?
- A.
The prognosis for normal psychomotor development is poor
- B.
Seizures stop after the first few days of life
- C.
Seizures are treated easily, regardless of which medicine is used
- D.
Further workup frequently is not indicated
- E.
Mortality in this condition is low
Postictal aphasia localizes the seizure focus to the:
- A.
Right temporal region
- B.
Left temporal region
- C.
Right parietal region
- D.
Left parietal region
- E.
Right frontal region
Advantages of Fos-phenytoin in comparison with phenytoin include:
- A.
Lesser risk of allergic reaction
- B.
Water solubility
- C.
Subcutaneous administration
- D.
Lesser protein binding
- E.
None of the above
Which of the following is not true about the following EEG?
- A.
Suggestive of multifocal epilepsy
- B.
Suggestive of right temporal dysfunction
- C.
Suggestive of unilateral temporal lobe epilepsy
- D.
Seizures are unlikely to be associated with postictal aphasia
- E.
Comorbidities, including cognitive and psychiatric, are common in patients with such EEG
Seizures from the dorsolateral frontal convexity are characterized by all except:
- A.
Forced head turningRelated posts:
New-Generation Antiepileptic Drugs
Other Pharmacological Therapies: Investigational Antiepileptic Drugs, Animal Models of Epilepsy, Hormonal Therapy, Immunotherapy
Procedures and Outcomes in Epilepsy Surgery
Magnetoencephalography and Magnetic Source Modeling
Epilepsy Secondary to Specific Mechanisms
Epilepsy Surgery Assessment and Testing
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