ABNORMAL NON-EPILEPTIC

Question 1

Intermixed diffuse intermittent theta in the most alert state is normal in__________

Answer 1

young adults

Question 2

T OR F

The slower the frequency, the higher the amplitude, and the greater the persistence, the more likely intermittent theta is abnormal.

Answer 2

T

Question 3

WHAT PATTERN?

Answer 3

An abnormal high-amplitude burst of diffuse intermittent

theta in an awake adult following a motor vehicle accident associated with

driving under the influence

Question 4

WHAT PATTERN IS SHOWN?

Answer 4

Generalized monomorphic 5 to 6-Hz theta frequencies

obtained during syncope in a patient undergoing head-up tilt table testing for

neurocardiogenic syncop

Question 5

Background slowing is defined as slowing of the normal posterior background activity to a frequency slower than the normal alpha rhythm frequency of <8 Hz and is an early finding of_________

Answer 5

encephalopathy

Question 6

WHAT PATTERN?

Answer 6

Slowing of the posterior dominant rhythm to 6 Hz. This welldefined

background is too slow even in a 65-year-old man

Question 7

______________appears in bursts of delta that is often high voltage, bisynchronous, and well formed.

Answer 7

Frontal intermittent rhythmic delta activity (FIRDA)

Question 8

FIRDA is most often associated with encephalopathies of toxic or metabolic origin, although it may also occur with subcortical Lesions such as a____________

Answer 8

deep midline lesion or increased intracranial pressure

Question 9

WHAT PATTERN?

Answer 9

Frontal intermittent rhythmic delta activity in a 67-year-old

patient with noncommunicating hydrocephalus. Note the slower 1.0- to 1.5-

Hz frequency and cerebral origin verified by eye monitors

Question 10

___________, like FIRDA, is a nonspecific finding in the EEG relative to etiology. OIRDA is demonstrated as a posterior predominant bisynchronous rhythmic delta slowing appearing in bursts

Answer 10

Occipital intermittent rhythmic delta activity (OIRDA)

Question 11

OIRDA has been noted to occur in association with ____________epilepsy, but is not an epileptiform abnormality unless intermixed spikes are present

Answer 11

generalized (absence)

Question 12

WHAT PATTERN?

Answer 12

ORIDA in a 6-year-old child with absence epilepsy.

Question 13

Continuous generalized slowing consists of polymorphic delta

activity that is continuous or near-continuous (>80% of the

record) and (at least as importantly)___________

Answer 13

unreactive

Question 14

WHAT IS CHARACTERISTIC?

Answer 14

Continuous irregular 1.5- to 3.0-Hz delta in a 66-year-old man with encephalopathy that was unresponsive. The above example of EEG is representative

of the entire record. No reactivity was noted during the EEG

Question 15

When seen during encephalopathy or coma, low-voltage EEG is typically associated with ______ AND _______

Answer 15

diffuse slowing and poor reactivity to somatosensory stimulatioN

Question 16

WHAT ABNORMALITY?

Answer 16

Low-voltage recording in a patient involved in a motor vehicle accident. The recording was obtained at a sensitivity of 2 μV/mm with no voltage

of >20 μV.

Question 17

A persistent hemispheric difference of _________Hz should be regarded as being abnormal when alpha asymmetry is seen

Answer 17

>1

Question 18

while the right hemisphere is often asymmetrical in respect to voltage, a persistent amplitude asymmetry of _________should be regarded as abnormal

Answer 18

>50%

Question 19

WHICH SIDE IS ABN?

Answer 19

Alpha asymmetry in a patient with an acute right frontoparietal ischemic infarction.

Question 20

WHICH SIDE IS NOT NORMAL?

Answer 20

Focal delta in a 28-year-old patient with right temporal polymorphic delta due to a anterior temporal ganglioglioma. Note the anterior–mid-temporal localization with loss of intermixed faster frequencies

Question 21

WHERE IS THE LESION?

Answer 21

Focal delta in a 28-year-old patient with right temporal polymorphic delta due to a anterior temporal ganglioglioma. Note the anterior–mid-temporal localization with loss of intermixed faster frequencies

Question 22

It consists of an intermittent monomorphic burst of delta frequencies maximal typically in a unilateral temporal derivation.

Answer 22

Temporal intermittent rhythmic delta activity (TIRDA)

Question 23

WHERE IS THE LESION?

Answer 23

There is a brief 2-sec burst of polymorphic delta activity in the posterior temporal-parietal region of the left hemisphere in a 55-year-old patient with a left subcortical white matter lacunar infarction

Question 24

WHERE IS THE LESION

Answer 24

A 75-year-old patient with an acute left frontal ischemic infarct. Note the left regional polymorphic delta that affects the entire hemisphere

Question 25

WHERE IS THE LESION?

Answer 25

A 64-year-old s/p right hemisphere infarct. Over the right

hemisphere, a well-formed alpha rhythm is not present (it is well formed on the

left) and is replaced by polymorphic slow waves (2 to 4 Hz).

Question 26

_________when localized is indicative of an underlying supratentorial lesion affecting the white matter of the ipsilateral hemisphere

Answer 26

Polymorphic delta activity

Question 27

Sleep spindles are initially evident in the first 2 months, and by ________of age are synchronous in normal children

Answer 27

2 years

Question 28

WHAT IS THE PROBLEM?

Answer 28

Asymmetry of sleep spindles in a 36-year-old patient with a

right thalamic glioma