Epilepsy

Question 1

The new definition of epilepsy includes the following points:

a) At least 2 unprovoked seizures occurring greater than 24 hours apart
b) One unprovoked (reflex) seizure
c) Probability of a high recurrence risk in the next 10 years
d) All of the above

Answer 1

D

Question 2

In 1997, about 700 children in Japan were brought to hospital due to seizures after watching cartoons (Pokemon) with prolonged blinking lights. What do you call this phenomenon?

a) Photosensitive epilepsy
b) Photoparoxysmal response
c) Ictal laughter
d) Psychogenic non-epileptic seizures

Answer 2

A

Question 3

A 21 year old female complained of feeling dizzy, followed by smelling unusual scent of sampaguita, then losing consciousness, and had GTCSz. The patient has

a) Focal seizures evolving to bilateral convulsive seizures
b) Generalized seizures
c) Absence seizures
d) Olfactory hallucination

Answer 3

A

Question 4

What is an epileptic aura characterized by a sense of familiarity to a particular event, person, circumstance, or feeling?

a) GTC seizures
b) Déjà vu
c) Jamais vu
d) Deja entendu

Answer 4

B

Question 5

What is the most common cause of epilepsy in adults?

a) inborn error of metabolism
b) stroke
c) tumor
d) infection

Answer 5

B

Question 6

What is the most common cause of epilepsy in the newborn?

a) inborn error of metabolism
b) hypoxia
c) tumor
d) infection

Answer 6

B

Question 7

What is the neuro-imaging modality of choice for epilepsy?

a) CT scan
b) 3 Tesla MRI
c) PET Scan
d) EEG

Answer 7

B

Question 8

What is an EEG finding seen in absence seizures?

a) triphasic waves
b) extreme delta brush sign
c) 3Hz generalized spike and wave activity
d) excessive beta activity

Answer 8

C

Question 9

What is a surgically remediable form of epilepsy?

a) Lennox-Gastaut Syndrome
b) juvenile myoclonic epilepsy
c) mesial temporal lobe epilepsy/hippocampal sclerosis
d) West syndrome

Answer 9

C

Question 10

The diagnosis of psychogenic non-epileptic seizures can be qualified based on history, physical examination and

a) routine EEG
b) serum prolactin levels
c) video EEG recording
d) high resolution PET-CT of the head

Answer 10

C

Question 11

What is the most abundant excitatory neurotransmitter in the brain?

a) Glycine
b) Glutamate
c) Acetylcholine
d) Dopamine

Answer 11

B

Question 12

What is the most common inhibitory neurotransmitter in the brain?

a) Aspartate
b) GABA
c) Acetylcholine
d) Serotonin

Answer 12

B

Question 13

Glutamate is received by 3 post-synaptic receptors. What is an example of a glutamate receptor?

a) Voltage-gated potassium channel (VGKC)
b) NMDA receptor
c) Muscarinic
d) Nicotinic

Answer 13

B

Question 14

Which receptor antagonist affects memory, learning, and retrieval?

a) NMDA
b) AMPA
c) GABA
d) None of the above

Answer 14

A

Question 15

Which AED has a Class A recommendation for adults with partial onset seizures?

a) Valproic acid
b) Carbamazepine
c) Oxcarbazepine
d) Lacosamide

Answer 15

B

Question 16

What is the mechanism of action of Levetiracetam?

a) Modifies fast sodium channels
b) Reduces glutamate at the synaptic level
c) Modifies SV2A protein
d) None of the above

Answer 16

C

Question 17

Levetiracetam and ethosuximide are associated with episodes of agitation upon resolution of EEG changes and decrease in seizure frequency. What is this phenomenon?

a) Forced normalization
b) Psychosis
c) Idiosyncratic reaction
d) Non epileptic seizures

Answer 17

A

Question 18

What AED is associated with metabolic syndrome and polycystic ovarian syndrome?

a) Phenytoin
b) Phenobarbital
c) Oxcarbazepine
d) Valproic Acid

Answer 18

D

Question 19

Weight loss is associated with which AEDs?

a) Topiramate
b) Valproic Acid
c) Levetiracetam
d) Zonisamide
e) A and D

Answer 19

E

Question 20

Metabolic effects on cholesterol and insulin levels may be caused by which AED?

a) Zonisamide
b) Valproic Acid
c) Perampanel
d) Phenobarbital

Answer 20

B