Abnormal EEG Flashcards
Lesions
Focal slowing ( polymorphic)
Hepatic encephalopathy
Generalized periodic discharges with triphasic morphology
What is the time after the seizure, but before the patient returns to baseline called?
Post-ictal
Define idiopathic.
No known cause for seizures
What type of seizure would have no change in consciousness and is of a brief duration?
Focal aware
Paralysis of an extremity that had focal clonic activity during a seizure is known as?
Todd’s paralysis
What type of seizure has twitching that moves across the body as a seizure moves across the surface of the brain?
Jacksonian seizure
What type of seizure has an ictal EEG that has rhythmic, synchronous beta that has increasing amplitude as the frequencies decrease and rhythmic activity that turns into spike-wave?
Focal aware seizures
A seizure type that has an alteration or LOC and the patient doesn’t respond to stimuli is called?
Focal unaware
What does the interictal activity during a focal unaware seizure look like?
Focal sharp waves and focal slowing
T or F: GTC seizures start with an aura.
FALSE
What is the tonic phase of a TC seizure?
The flexion of extremities and muscle tension
T or F: SE can occur with any seizure type.
TRUE
What is the first priority when a patient is having a seizure?
Keeping the patient safe
What should you not do when responding to a seizure?
Do not put anything in the patient’s mouth
A patient that has altered consciousness, visual disturbances, and balance problems would have signs of?
A concussion
When there is a loss of memory prior to an event it is known as?
Retrograde amnesia
A bleed that occurs in the brain on the opposite side of the skull insult is called?
Contracoup
A subdural hematoma is located?
Below the dura and above the arachnoid
A bleed located between the skull and the dura is called?
Epidural hematoma
T or F: Concussions typically do not have changes in the EEG associated with them.
TRUE
A bruise of the brain and TBI would be a?
Contusion
T or F: A background activity of less than 8 Hz is always abnormal for all age groups.
FALSE
Consistent amplitude alpha asymmetry over _____ may be clinically significant.
50%
With frequency asymmetries, the side with ___ frequency is more abnormal.
Lower
Spindle coma is comprised of primarily _____ waves.
Beta waves
Greater than 30 Hz. 2. Can accurately localize octal onset. 3. Are visible on intracranial electrodes are characteristics of?
Gamma wave
Focal ADA is a reliable indicator of?
Focal supratentorial lesion
T or F: EEG is not a good tool to localize a lesion.
TRUE
FIRDA activity will show as ____ and eye movement will show as _____
In phase and out of phase
The pattern most associated with TLE is?
TIRDA
Discharges that have abrupt onset and sudden termination are clear from the background are known as?
Paroxysmal activity
What paroxysmal activity is more specific for seizure diagnosis?
Spike/Spike-Wave
A sharp has a wave duration of?
70 - 200 msec
IED stands for?
Interictal epileptiform discharges
Spikes recorded with maximum amplitude over the central or midtemporal electrodes are seen in?
BECTS
What is the most common seizure type?
Temporal lobe epilepsy
What type of seizure has the following symptoms: Auras, deja vu, and jamais vu?
MTLE
What seizure location would have symptoms of clonic twitching, bicycling, and GTC seizures?
Frontal lobe seizures
T or F: Frontal lobe octal and interictal activity is easy to miss using scalp electrodes.
TRUE
Seizures that can cause visual field loss originate from?
The occipital lobe
T or F: JME and Absence seizures are examples of idiopathic epilepsies.
TRUE
What activation procedure induces 3 Hz spike and wave in patients that have absence seizures?
HV
Childhood absence seizures occur in patients of what age?
Between 3 - 7 yrs of age
A syndrome that displays repetitive eye blinking after eye closure and generalized spike-wave bursts of 4 - 6 Hz is called?
Jeavons Syndrome
What EEG patterns may indicate that a patient has GTC seizures?
Photoparoxymal responses and generalized spike-wave
T or F: The patient’s background activity should return to normal immediately after an event if the patient has a pseudo seizure.
TRUE
This tracing is an example of?
3 Hz Spike and Wave
The disorder associated with the EEG of a 1 year old male with severe intellectual disabilities and generalized seizures is?
Infantile spasms
When would expect to see epileptiform activity in patients with JME?
Shortly after waking
What type of seizures are characterized by loss of muscle tone?
Atonic seizures
What does the EEG pattern with very high voltage, irregular, asynchronous delta waves with random spikes indicate?
Hypsarrhythmia
The majority of infantile spasms patients will respond to what treatment?
ACTH
A patient with SSW, intellectual disability, and generalized seizures may have what condition?
Lennox-Gastaut
This disorder that occurs with sudden dysphasia in a normal, healthy 3 - 9 year old is:
Landau-Kleffner Syndrome
Patients that have a decline in IQ, deterioration in language, and behavioral changes may have what condition?
CSWS
What is the most common seizure disorder in infants and young children?
Febrile seizures
What disorder occurs secondary to a measles infection?
Subacute Sclerosing Panencephalitis
What disorder presents as progressing dementia and myoclonus, can be transmitted via tissue or medical instruments, and shows triphasic waves on EEG?
CJD
What does SIRPIDs stand for?
Stimulus induced rhythmic periodic or ictal discharges
What occurs most often after acute, large destructive cerebral lesions?
LPDs
True or False: An increase in muscle activity is an indicator of octal activity.
FALSE
What does a post-ictal EEG show after a GTC seizure?
Voltage suppression followed by low amplitude delta
True or False: Focal aware seizures can occur without scalp EEG changes.
TRUE
What characteristics must be met to qualify for SE?
A single epileptic seizure lasting more than 5 minutes or a series of epileptic seizures for at least 5 minutes and function is not fully regained between events
What are gelastic seizures?
Laughing spells
What seizure disorder has a high mortality rate if not treated promptly?
Generalized convulsive status
Typical triphasic waves are commonly seen in _____ encephalopathy.
Hepatic
What syndrome has the following characteristics: 1. Occurs with aspirin use in children who have fevers. 2. Burst suppression. 3. 14 and 6 Hz positive spike bursts?
Reye’s Syndrome
EEG is very sensitive to detecting what condition?
Cerebral ischemia
In the case of severe ischemia, an EEG would show what?
Flattening of the EEG
What EEG patterns are associated with a coma after severe hypoxia?
- Biphasic waves
- Triphasic waves
- BiPLEDs
- Burst suppression
- Alpha coma
SSPE is the result of what?
Chronic measles infection
What is the main waveform seen in patients with CJD?
Triphasic waves
At what age does Batten’s disease occur?
Late infancy/early childhood
What is the correlation of EEG waves and the degree of dementia?
The worse the dementia, the more EEG abnormalities are seen
What is the main characteristic of the EEG in a patient with Huntington’s Disease?
Low voltage activity
What is the unique EEG pattern that helps diagnose anti-NMDA receptor encephalitis?
Extreme delta brush
Medication impact on the EEG is dependent on what factors?
- The damage of the drug
- The duration of exposure to the drug
- Any preexisting EEG abnormalities
Beta activity is seen primarily as an effect of which group of drugs at therapeutic levels?
Benzodiazepines
True or False: At a therapeutic dose, valproic acid does not have an impact on the background EEG activity.
TRUE
The EEG of a patient with severe intoxication will show what?
An increase in delta and theta
What medications can be used for induced therapeutic hypothermia?
- Barbiturates
- Propofol
- Ketamine
Which location is the EEG less able to detect tumors?
Parietal lobe
Local polymorphic delta activity is present in the location of what condition?
Ischemic stroke
True or False: LPDs can indicate a large brain infarction.
TRUE
True or False: Focal slow waves are common in the elderly population.
TRUE
What are the types of meningitis?
- Viral
- Bacterial
- Fungal
A brain abscess is usually of what origin?
Bacterial
What would you expect to see on an EEG of a patient with Reye’s Syndrome?
Increased theta and delta
What would an EEG show on a patient with AIDS?
No specific pattern
What is the treatment for CJD?
There is no known treatment
The EEG for a patient with generalized anxiety disorder would show what?
Minimally slow or bordering normal variants
What is encephalopathy?
Global brain dysfunction
What are some patterns that can be seen in a patient with hypoxia?
- Slowing of background
- FIRDA
- Periodic bi or triphasic waves
- Myoclonic jerks
An infarct is defined as what?
Neuronal death due to lack of oxygen
What occurs when a blood clot occludes an already narrowed artery?
Thrombotic ischemic stroke
What is it called when blood spills into brain tissue from a burst vessel or artery?
Hemorrhagic stroke
What occurs when a clot from a larger blood vessel is carried to a smaller vessel, gets stuck, and restricts or occludes blood flow?
Embolic ischemic stroke
True or False: Sleep spindles present 2 days after a brain injury indicate a poor prognosis.
FALSE
CJD
Progressive dementia
benign Rolandic Epilepsy
childhood boys more than girls, seizure typically upon waking or right before falling sleep. symptoms: numbness twitching, tingling on face and tongue
