CLINICAL NEUROLOGY - Seizure Disorders

Question 1

Diagnosing seizures in youth with

intellectual disability is more challenging because? (2x)

Answer 1

More repetitive and stereotyped

behaviors at baseline

Question 2

Most common aura symptom preceding complex partial seizures? (2x)

Answer 2

Anxiety

Question 3

Medication that may worsen juvenile

myoclonic epilepsy?

Answer 3

Oxcarbazepine

Question 4

Preliminary symptom in Landau-Kleffner syndrome?

Answer 4

Acquired aphasia

Question 5

4 yo boy w/ previously normal
development is losing responsiveness to parents verbal communication over the past year. He has had 2 tonic-clonic seizures and his EEG shows bilateral independent spike and wave discharges. Diagnosis?

Answer 5

Landau-Kleffner Syndrome

Question 6

Diagnosis of a teenager who has several 2-3 minute episodes of being “in a daze,” smacking lips, fumbling with clothing followed by confusion and sleepiness?

Answer 6

Complex partial seizure

Question 7

Psychotic 17 yo has seizures, most likely lesion location on MRI?

Answer 7

Left temporal lobe

Question 8

What medication used for seizures can decrease IQ?

Answer 8

Phenobarbital

Question 9

Repetitive transcranial stimulation can

cause?

Answer 9

Induction of seizure

Question 10

Type of EEG pattern seen in an adolescent with absence seizures and new onset myoclonic jerks, worse in morning after staying up late to work on book report?

Answer 10

Brief bursts of generalized 3.5 to 4.0-Hz spike-and-waves

Question 11

Treatment for child with multiple staring spells and EEG with symmetrical 3-Hz spike and waves?

Answer 11

Ethosuximide

Question 12

8 yo with ADHD well controlled on long acting stimulant with concern of episodes staring out the window during school. EEG shows diffuse alpha rhythm during hyperventilation. Diagnosis?

Answer 12

Normal behavior

Question 13

Child with declining grades in school with staring spells for 8-10 seconds associated with eye blinking several times per day.
Next step?

Answer 13

EEG

Question 14

Increased risk of what medication side effect would you be concerned about in a HLA-B*1502 positive female adolescent patient with epilepsy, well controlled on antiepileptic, now presenting with poor concentration, trouble with memory, hair growth on chin, and hyperplasia of gingiva?

Answer 14

Stevens-Johnson syndrome

Question 15

7 yo is conscious during 3 minute episode of mouth twitching and generalized jerking movements. Prognosis?

Answer 15

Spontaneous improvement without treatment

Question 16

What area of the brain are you trying to approximate on an EEG by using nasopharyngeal electrodes inserted into the nostrils?

Answer 16

Basal temporal lobe