AES self test questions Flashcards
A 14-year-old girl is being started on an antiepileptic drug after 3 unprovoked seizures. How should you counsel her and her parents with regard to reproductive health?
Counsel her on the teratogenic risks as part of choice in treatment
A 24-year-old graduate student has new-onset epilepsy and is concerned about the potential cognitive side effects of antiepileptic drugs. Which set of antiepileptic drugs listed below poses the lowest overall risk for cognitive side effects?
Gabapentin, Lamotrigine and LVT
A 56-year-old right-handed man is undergoing a routine EEG because he had a recent seizure. The EEG’s sensitivity is at 7 microvolts/mm and filter settings are 1.0 – 70 Hz. What is the most appropriate interpretation of the displayed EEG page?
Mu rhythm
A 78-year-old man is admitted with an intracerebral bleed. An EEG is obtained because of the patient’s altered mental status. What is the most appropriate interpretation of the displayed EEG page?
PLEDs
An 83-year-old man has a cardiac arrest at home. He is resuscitated and brought to the hospital. An EEG is obtained. What is the most appropriate interpretation of this sample, which is representative of the entire EEG?
BS and right frontal sharp waves
A 16-year-old boy with new-onset epilepsy is being started on an antiepileptic drug (AED). His parents are concerned about potential side effects of the AED. Which of the following statements about the neuropsychological effects of AEDs is the most accurate?
AEDs can affect psychomotor speed, vigilance and risk is increased with rapid titration, higher dose and polytherapy
A 24-year-old woman is planning to marry and seeks advice about the potential teratogenic risks from antiepileptic drugs. Based on current human evidence, when used as monotherapy, which set of antiepileptic drugs below poses the lowest overall risk for major congenital malformations from fetal exposure?
CBZ, LMT and LVT
A 72-year-old man is admitted with an intracerebral bleed. An EEG is obtained in the ICU. The patient is comatose and is being mechanically ventilated. What is the most appropriate interpretation of the displayed EEG page?
Artifact (ventilator) and low voltage background.
A 36-year-old man with treatment-resistant focal epilepsy has undergone electrode implantation that includes the displayed 2 x 8 grid placed at the left inferior temporal lobe. Contacts #1 through 9 are most medial and contacts #8 through 16 are most lateral. The “X” marks the onset of the patient’s aura. Assuming no epileptiform activity at his seizure onset is seen in any additional electrodes that are not shown, what is the most appropriate interpretation of the displayed EEG page?
The area of seizure onset is not covered by electrodes.
A 28-year-old woman has medically resistant epilepsy. The figure displays her interictal PET scan and MRIs with FLAIR and T1 images. What findings are most pertinent to her epilepsy?
Right frontal FCD
Which one of the following semiologic features suggests psychogenic nonepileptic seizures rather than epileptic seizures?
Stuttering speech during seizure
A 19-year-old man presents with a history of brief episodes of thrashing movements that occur in clusters during sleep. His disorder is most likely to be associated with mutations in which gene(s)?
Genes encoding the nocotinic Ach receptor
Which of the following HLA alleles is associated with the highest risk of carbamazepine-induced Stevens-Johnson syndrome and toxic epidermal necrolysis?
HLA-B 1502
Which type of aura is most likely to be associated with seizures of mesial temporal origin?
Abdominal
What is the name of the area of cortex capable of generating interictal spikes on EEG or MEG?
Irritative zone
A 40-year-old man presents with frequent (up to 50 per day), very brief (3 to 4 seconds) dystonic seizures affecting one arm and the ipsilateral face or leg. Subsequently, he develops amnesia, confusion, hallucinations, and sleep disturbances. He is most likely to have high levels of which antibody?
Anti-LGI1
Traumatic brain injury is thought to cause cortical hyperexcitability as a result of multiple mechanisms, including which of the following?
Reduced GABAergic inhibition due to loss of inhibitory interneurons
Which of the following statements regarding the role of copy number variants in epilepsy is correct?
Copy number variants are more common in individuals with generalized epilepsy and intellectual disability than in individuals with only generalized epilepsy.
Which of the following statements regarding migraines and epilepsy is correct?
People with epilepsy are at increased risk of migraine and people with migraine are at increased risk of epilepsy.
Adjunctive therapy with which of the following AEDs is most likely to cause increased aggression as a side effect, particularly in adolescents?
Perampanel
Which of the following seizure models is used as the initial “gatekeeping” screen by the NINDS Anticonvulsant Screening Program (ASP) despite failing to identify the efficacy of levetiracetam?
Maximal electroshock (MES)
Which of the following statements regarding neurostimulation for the treatment of treatment-resistant right lesional temporal lobe epilepsy is correct?
Responsive neurostimulation, vagus nerve stimulation, and thalamic stimulation are all less effective than resective surgery.
Which one of the following AEDs may aggravate seizures in juvenile myoclonic epilepsy?
Lamotrigine
Which of the following characteristics most strongly suggests psychogenic nonepileptic seizures?
Seizure in the office and history of fibromyalgia and chronic pain
Which of the following is an advantage of subdural grid recordings over intracerebral depth electrode recordings?
Ability to record functional information from the cortex.
Which of the following statements regarding diffusion tensor imaging in epilepsy is true?
Technical challenges for diffusion tensor–based tractography include the presence of crossing fibers.
Flag for Review
Which of the following is not essential in an epilepsy protocol MRI scan?
Gadolinium
In temporal lobe epilepsy, depression may be associated with hyperexcitability of the network that includes the hippocampus and what other structure?
Inferior frontal lobe (BA 25)
Genomic testing and genetic diagnosis of nonlesional epilepsies such as Severe Myoclonic Epilepsy of Infancy rest on which of the following?
Detailed clinical assessment complemented with analysis of the SCN1A gene single-nucleotide polymorphisms and copy number variants
Combined EEG and fMRI is a useful method in the investigation of the epileptic focus for which principal reason?
It is a noninvasive means of investigating the whole brain.
Epilepsy monitoring unit studies assessing patients’ recall of seizures reveal which of the following?
There is a greater incidence of loss of memory in left temporal lobe seizures.
Which lesion is most easily visualized on a routine MRI of patients with epilepsy?
Cavernoma with hemorrhage
The most common histopathological subtype of hippocampal sclerosis in the ILAE consensus classification shows which of the following?
Cell loss in CA1 and CA4 regions
How frequent is atypical language dominance in temporal lobe epilepsy?
20-30%
Which two fiber tracts have been implicated in verbal memory performance in patients with temporal lobe epilepsy?
Uncinate and inferior longitudinal fasciculus.
Which of the following measurements can be derived from diffusion tensor imaging data?
FA
Approximately what percentage of newly diagnosed patients with epilepsy ultimately achieve seizure freedom for 1 year or more once started on AEDs?
68%
Which of the following statements about the point prevalence of epilepsy in the USA nursing home population is correct?
60 per 1000 (6%)
Which pair of antiepileptic drugs is least likely to be affected by drug–drug interactions?
LVT and gabapentin
Which of the following AEDs does not reduce the efficacy of oral contraceptive pills?
VPA