II-F. Activation techniques / contraindications Flashcards
A 7 year old female presents with spells of “spacing out” reported by teachers at her school. Of the following, which activation procedure is of most importance in assisting with diagnosis?
A) Sleep deprivation
B) Hyperventilation
C) Photic stimulation
D) Sleep
Hyperventilation
Which of the following is most useful in the evaluation of temporal lobe seizures?
A) Awake EEG
B) Photic stimulation
C) Hyperventilation
D) Sleep EEG
Sleep EEG
Photic light should be how far from a patient’s eyes?
A) 12 inches
B) 6 inches
C) 3 inches
D) 24 inches
12 inches
What other EEG pattern would you expect to see in the patient with prominent photic driving response?
A) Lambda
B) Slowing in posterior region
C) Epileptiform discharges
D) OIRDA
Lambda
HYPERVENTILATION
A) Hyperglycemia
B) Hypercapnia
C) Hypocapnia
D) Hypoatremia
Hypocapnia
A subharmonic photic driving response is:
A) The exact frequency of the flash strobe
B) Twice the frequency of the flash strobe
C) Attenuation for duration of flash strobe
D) Half the frequency of the flash strobe
Half the frequency of the flash strobe
When using the photic stimulator, the flash rate which would most commonly activate seizure activity would be
A) 4-7 flashes/second
B) 15-18 flashes/second
C) 1-3 flashes/second
D) 25-30 flashes/second
15-18 flashes/second.
What is a sub harmonic response to photic stimulation?
A) Photic driving double the speed of the flash rate
B) An abnormal response to the photic stimulation
C) Photic driving at the exact frequency to the frequency rate
D) Photic driving at half the speed of the flash rate
Photic driving at half the speed of the flash rate
Photoparoxysmal response:
A) EMG artifact time locked with flash frequency
B) Sub-harmonic pattern
C) Occipital pattern linked with flash rate
D) EEG response to light with spikes, spike-wave discharge and/or intermittent slow waves
EEG response to light with spikes, spike-wave discharge and/or intermittent slow waves.
What type of response to photic stimulation is characterized by generalized spike-and-wave discharges continuing after the last flash?
A) Photic recruiting
B) Photoparoxysmal
C) Photomyogenic
D) Photoelectric
Photoparoxysmal
Photic stimulation is most effective in evoking epileptiform abnormalities in patients with
A) a family history of seizures
B) focal occipital seizures
C) metabolic coma
D) syncope
a family history of seizures
Which of the following would be considered an abnormal EEG presentation to photic stimulation?
A) Photomyogenic
B) Photoelectric
C) Photoparoxysmal
D) Photic driving
Photoparoxysmal
Which of these is a contraindication for the activation procedure hyperventilation (HV)?
A) Photosensitivity
B) Sickle cell anemia or sickle cell trait
C) Tuberous sclerosis
D) Multiple sclerosis
Sickle cell anemia or sickle cell trait
An asymmetric photic driving response right greater than left is:
A) A common finding
B) Indicative of severe cerebral dysfunction
C) Seen only in Absence seizures
D) Always abnormal
A common finding
During hyperventilation, a 9 year-old patient develops generalized 100 - 300 microvolts slowing. If, within thirty seconds post hyperventilation, the record returns to its pre-hyperventiliation state, the reaction would be
A) suggestive of a tumor
B) compatible with a seizure disorder
C) suggestive of a metabolic disturbance
D) a normal response to hyperventilation
a normal response to hyperventilation.
Photic Driving is most common at what frequencies?
A) 16-20 Hz
B) 25-30 Hz
C) 9-13 Hz
D) 1-4 Hz
9-13 Hz
Photic induced epileptiform discharges are most likely associated with
A) meningitis
B) hepatic encephalopathy
C) barbiturate withdrawal
D) Down syndrome
barbiturate withdrawal.
Which of the following procedures can be considered to be a “non-standard” activation:
A) Photic stimulation
B) Eyes open/closed
C) Listening to music
D) Sleep
Listening to music
Which of the following activation procedures should be AVOIDED in a patient with a recent intracranial hemorrhage?
A) Photic stimulation
B) Hyperventilation
C) Sleep
D) Mental exertion
Hyperventilation
Atypical Photic Response
A) Photic driving
B) Harmonic driving
C) Delta driving
D) Photomyogenic driving
Delta Driving
Photic stimulation should be performed
A) With light 24” away from patient
B) While awake
C) During hyperventilation
D) During sleep
While awake
What could be the cause for a build-up of slowing several minutes after the hyperventilation has been completed?
A) CVD
B) Moyamoya disease
C) Patient continues to hyperventilate
D) Focal lesion
Moyamoya disease
An EEG obtained during sleep is of most value in which condition?
A) Vascular diseases
B) Space occupying lesions
C) Psychiatric disturbances
D) Complex partial seizures
Complex partial seizures
Which activity does NOT typically cause an attenuation of the posterior dominant alpha rhythm in the normal adult?
A) Relaxed wakefulness with eyes closed
B) Having the patient solve a math problem with eyes closed
C) Light sleep
D) Having the patient open their eyes
Relaxed wakefulness with eyes closed
