Seizure/EEG

Question 1

16y/o pt after having 1 grand mal seizure.
Parents noted on multiple occasions pt has sudden jerks of entire body, causing him to drop 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 - lateralized, high voltage sharp waves arising in L temporal region w/ slow wave repeating at 2-3 sec intervals.
CT - low density lesion in L temporal lobe
Dx?

Answer 2

Herpes simplex encephalitis

Question 3

8 y/o has episodes of staring into space and then blinking for few seconds. EEG shows?

Answer 3

3 cycles per sec spike and wave activity

Question 4

40 y/o has episodes of flailing arms and tonic postures described as “fencing.”
EEG confirms seizure classified as which type?

Answer 4

Frontal lobe

Question 5

10 y/o child w/ frequent episodes of brief lapses of consciousness w/o premonitory sxs.
Lasts 2-10 secs, followed by immediate and full resumption of consciousness w/o awareness of what happened.
These ictal episodes most likely caused by what kind of seizures?

Answer 5

Absence seizures

Question 6

EEG showing posterior alpha and anterior beta activity in?

Answer 6

Relaxed adult w/ eyes closed

Question 7

Diagnostic value of transient paresis or aphasia after seizure?

Answer 7

Localizes focus of seizure

Question 8

28 y/o F. Recent onset episodes of altered behavior lasting 1-2 mins.
Husband notes if occurs when cooking pt will place clean silverware back in dishwasher. Also notes she does complex drawing mvmts he is unable to interrupt. Pt has no recollection of events.
MRI - normal.
Dx?

Answer 8

Complex, partial seizures

Question 9

1st seizure w/ focal onset and secondary generalization in 58 y/o pt is likely consequence of?

Answer 9

Glioblastoma multiforme

Question 10

EEG finding of 4-6 Hz irregular, polyspike activity in pt with generalized seizures is characteristic of?

Answer 10

Juvenile myoclonic

Question 11

Which surgical procedure can be used in the tx of epilepsy refractory to meds?

Answer 11

Electrical stimulation of the vagus nerve

Question 12

EEG findings expected in comatose pt w/ hepatic encephalopathy?

Answer 12

Triphasic waves

Question 13

3 days s/p cardiac arrest and CPR, 73 y/o M is comatose.
Eyes are open, but does not fix and follow.
Doll’s eyes elicit full horizontal eye mvmts.
Spontaneous limb mvmts are symmetrical.
Reflexes - mildly hyperactive.
EEG shows?

Answer 13

Burst suppression pattern

Question 14

Pt has seizures which get controlled. Then pt starts to have paranoid delusions.
What type of seizures?

Answer 14

Complex partial

Question 15

New onset seizures.
Multiple subcutaneous nodules, axilla freckling.
Dx?

Answer 15

NF type 1

Question 16

40 y/o pt.

New onset seizures w/ BL thrashing mvmts. What suggest non-epileptic cause?

Answer 16

Following commands

Question 17

Characteristics of normal adult alpha rhythm on EEG?

Answer 17

Intermittent and posterior dominant

Question 18

EEG biofeedback training is efficacious for what d/o?

Answer 18

GAD

Question 19

49 y/o pt develops seizure d/o difficult to control.
CSF - lymphocytic pleocytosis w/ many RBCs.
MRI - T2 hyperintensity in L temporal lobe, w/ gadolinium enhancement in this area in T1 weighted image.
EEG - periodic discharges.
Dx?

Answer 19

Herpes simplex encephalitis