Seizure/EEG

Question 1

16 yo pt brought to psychiatrist attention after having single grand mal seizure. Patient’s parents have noted on occasion patient has sudden jerks of entire body, resulting in dropping objects. EEG: rare 4-6Hz irregular polyspike/ wave bursts. Dx?

Answer 1

Juvenile Myoclonic epilepsy

Question 2

Fever, HA, seizures, confusion, stupor, and coma, evolving over several days. EEG with lateralized high voltage sharp waves arising in the L temporal region with slow wave repeating at 2-3 sec intervals. CT low density lesion in L temporal lobe.

Answer 2

HSV encephalitis

Question 3

8 yo has episodes of staring into space and then blinking for a few seconds. EEG will show?

Answer 3

3 cycles per second spike and wave activity

Question 4

40 yo has episodes of flailing of the arms and tonic postures described as “fencing”. EEG confirms seizure. Which type?

Answer 4

Frontal lobe

Question 5

10 yo child with frequent episodes of brief lapses of consciousness without premonitory symptoms. Lasts 2-10 seconds, followed by immediate and full resumption of consciousness without awareness of what has happened. These ictal episodes most likely caused by what kind of seizure?

Answer 5

Absence

Question 6

EEG reveals posterior alpha and anterior beta activity is most likely to have been obtained by whom?

Answer 6

A relaxed adult with eyes closed

Question 7

What is the dx value of transient paresis or aphasia after seizure?

Answer 7

Localizes the focus of seizure

Question 8

28 yo female referred to psych d/t recent onset episodes of altered behavior lasting 1-2 minutes. Husband notes it occurs when cooking patient will place the clean silverware back in the dishwasher. Also notes she does drawing movements he is unable to interrupt. Pt has no recollection of the events. MRI scan is normal. Dx?

Answer 8

Complex partial seizures

Question 9

1rst seizure with focal onset and secondary generalization in a 58 yo pt is likely the consequence of?

Answer 9

Glioblastoma multiforme

Question 10

The EEG finding of 4-6hz irregular polyspike activity in a pt with generalizes seizures is characteristic of which of the following forms of epilepsy?

Answer 10

Juvenile myoclonic

Question 11

Which of the following surgical procedures can be used in the treatment of epilepsy refractory to meds?

Answer 11

Electrical stimulation to vagus nerve

Question 12

What is the MC Comorbidity psych disorder in pts with epilepsy?

Answer 12

MDD

Question 13

What EEG findings are expected in a comatose pt with hepatic encephalopathy?

Answer 13

Triphasic waves

Question 14

3 days s/p cardiac arrest and CPR, 73 yo man is comatose. His eyes are open but he doesn’t fix and follow with his eyes. Doll’s eyes elicit full horizontal eye movements. His spontaneous limb movements are symmetrical. Reflexes: middle hyperactive. The EEG shows?

Answer 14

Burst suppression pattern

Question 15

An increase in Beta frequency during an awake EEG is caused by what type of medication?

Answer 15

Sedatives