Seizure Surgery Flashcards
Region of cortex produces interictal spikes detected on scalp or invasive EEG, magnetoencephalography (MEG), or triggered fMRI. Isolated spikes that generally do not produce clinical symptoms are called?
● A. Epileptogenic zone
● B. Ictal onset zone
● C. Symptomatogenic zone
● D. Irritative zone
● E. Functional deficit zone
D. Irritative zone
What surgical procedure is recommended for drop attacks?
● A. Hemispherectomy
● B. Amygdalohippocampectomy
● C. Callosotomy
● D. Temporal lobectomy
● E. None of the above
C. Callosotomy
Resection of 6 to 7 cm of temporal lobe on nondominant side can lead to which of the following?
● A. Partial contralateral upper quadrant homonymous hemianopsia
● B. Complete contralateral upper quadrantanopsia
● C. Partial contralateral lower quadrant homonymous hemianopsia
● D. Speech deficit
● E. Memory disturbance
A. Partial contralateral upper quadrant homonymous hemianopsia
After seizure surgery, antiepileptic drugs must be continued for how long?
● A. 2 months
● B. 6 months
● C. 1 to 2 years
● D. 2 to 4 years
● E. No need
C. 1 to 2 years
Follow-up MRI after seizure surgery is obtained after how long?
● A. 1 month
● B. 3 months
● C. 6 months
● D. 1 year
● E. 2 years
B. 3 months
After seizure surgery, if there is worthwhile reduction in seizures, then what would be the class according to the modified Engel classification?
● A. Class I
● B. Class II
● C. Class III
● D. Class IV
● E. None of the above
C. Class III
Which of the following is the largest group of surgical candidates among the types of seizures that are amenable to seizure surgery?
● A. Focal onset seizures of temporal origin
● B. Focal onset seizures of extratemporal origin
● C. Symptomatic generalized seizures
● D. Unilateral, multifocal epilepsy associated with infantile hemiplegia syndrome
● E. All of the above
A. Focal onset seizures of temporal origin
Noninvasive evaluation techniques for seizures include all of the following except?
● A. Video EEG monitoring
● B. CAT scan
● C. PET scan
● D. Wada test or intracarotid amytal test
● E. SPECT scan and MEG
D. Wada test or intracarotid amytal test
Which of the following are the surgical techniques of seizure surgery?
● A. Resections (resection of epileptic focus or anterior temporal lobectomy or resection of neocortical areas)
● B. Disconnections (section of corpus callosum, functional hemispherectomy)
● C. Stimulations (vagus stimulation or deep brain stimulation)
● D. All of the above
D. All of the above
Following are the indications of corpus callosotomy except?
● A. Frequent episodes of atonic seizures
● B. Possibly for generalized seizure disorder with unilateral hemisphere damage
● C. Patients with speech and dominant handedness in opposite hemisphere
● D. Some patients with generalized seizures without identifiable, resectable focus
C. Patients with speech and dominant handedness in opposite hemisphere
Disconnection syndrome can occur with commissural resection which includes left tactile anomia, left-sided dyspraxia, pseudohemianopsia, right-sided anomia for smell, or decreased
spontaneity of speech. How much time a patient usually requires to adapt to most daily activities?
● A. 2 to 3 months
● B. 8 to 9 months
● C. 1 to 2 years
● D. 3 to 4 years
● E. 6 to 7 years
A. 2 to 3 months
Which of the following are the approaches for selective amygdalohippocampectomy?
● A. Transcortical through inferior temporal gyrus
● B. Transsylvian
● C. Subtemporal through temporal fossa approach
● D. All of the above
D. All of the above
Risks of seizure surgery include all of the following except?
● A. Removal of essential areas of cortex
● B. Memory impairment
● C. Injury to medullary core underlying cortical resection
● D. Injury to vessels in area of resection
● E. Injury to nearby cranial nerves
B. Memory impairment
Postoperative management for seizure surgery includes all of the following except?
● A. Observation in ICU for 24 hours
● B. Load appropriately with IV phenytoin or Keppra
● C. 10 mg dexamethasone IV before surgery followed by every 8 hours as necessary
● D. Antiseizure medication is not needed beyond 2 to 4 weeks
● E. Neuropsychiatric evaluation should be done after 6 to 12 months
D. Antiseizure medication is not needed beyond 2 to 4 weeks
Which of the following are included in the modified Engel and ILAE classification of seizure surgery outcome?
● A. Class 1 is seizure-free or residual auras
● B. Class 2 is rare disabling seizure (less than three complex
partial seizures per year)
● C. Class 3 is worthwhile improvement
● D. Class 4 is no worthwhile seizure improvement
● E. All of the above
E. All of the above
