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EEG Board Exam Questions with Complete Solutions
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EEG Board Exam Questions with Complete Solutions
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EEG Board Exam Questions with CompleteSolutions
End stage liver disease - ANSWER This disease can present with hyperammonemia and
generalized periodic waves with triphasic morphology. They are bilaterally synchronous and
usually frontally predominant and exhibit three phases (i.e. negative, positive, negative).
Triphasic waves can also be seen in ESRD and other forms of metabolic encephalopathy.
Subdural Hematoma - ANSWER Hemispheric asymmetry with the lower amplitude discharges
localizing to the affected hemisphere.
HSV Encephalitis - ANSWER Due to the predilection for the temporal lobes, patients will present
with lateralized periodic discharges (LPDs) most prominent in temporal leads.
Stroke - ANSWER Shows focal irregular theta/delta activity with LRDA or LPDs.
Creuztfeldt-Jakob Disease (CJD) - ANSWER Generalized periodic discharges, spikes, and spike-
waves with a disorganized background.
Fatal familial insomnia (FFI) - ANSWER Loss of sleep spindles.
Subacute sclerosing panencephalitis - ANSWER periodic high-amplitude complexes with high-
amplitude bisynchronous delta waves, frontal rhythmic delta activity, generalized periodic
discharges, electrodecremental periods following EEG complexes, and focal spike and slow-
waves.
,Tay-Sachs disease - ANSWER Slow background with or without multifocal
epileptiform discharges.
Alzheimer's disease (AD) - ANSWER Slow background with or without multifocal epileptiform
discharges.
Angelman Syndrome - ANSWER Notched delta activity.
Lithium toxicity - ANSWER Generalized delta/theta activity with multifocal spikes.
Hypoxic ischemic encephalopathy - ANSWER Can present secondary to cardiac arrest, drug
overdose, drowning, etc.
EEG can have a variable pattern.
Poor prognostic EEG findings include: burst suppression, monorhythmic patterns, alpha
coma (unless in the setting of reversible cause for coma such as metabolic dysfunction,
sedative drugs, etc.), generalized periodic discharges, and electrocerebral inactivity (ECI).
brain death - ANSWER Criteria for WHAT include the use of at least 8 scalp electrodes, 10 cm
interelectrode distances, normothermia, and electrocerebral silence, and sensitivity of least
2 microvolts per millimeter for at least 30 minutes.
Focal onset seizures - ANSWER Previously called partial seizures, focal onset seizures can
be subclassified as focal aware or focal with impaired awareness.
Focal aware seizure - ANSWER Patient is aware of the ictal symptoms during focal seizure activity.
This is often seen with frontal, parietal and lateral or non-dominant temporal seizures.
An example is a patient who can report a "Jacksonian march" seizure semiology which can
be more formally identified as a focal motor aware seizure.
, Focal seizure with impaired awareness - ANSWER Self-awareness is not maintained with focal
seizure activity, often due to involvement of the hippocampus.
An example is a patient that is temporal lobe seizure with associated semiology of starring and
unresponsiveness.
Formally called complex partial seizures.
Motor onset - ANSWER Automatisms, clonic, hyperkinetic, etc.
Non motor onset - ANSWER Behavior arrest, sensory, emotional, etc.
Temporal lobe seizure - ANSWER Can present with an aura of unusual smell, taste,
automatisms (lip smacking, hand rubbing), or feeling of deja vu.
The most common focal epilepsy.
Parietal lobe seizure - ANSWER Can present with hemibody parasthesias.
Frontal lobe sieuzre - ANSWER Diverse, but often involves hyperkinetic or bilateral atypical
movements, such as clapping and leg bicycling. These may be brief and sudden, arise from sleep
and have minimal post-ictal confusion.
Focal seizure to bilateral tonic clonic - ANSWER Presents with a focal onset of symptoms with
progression to involve the whole cortex and bilateral tonic clonic acitivity.
Use to be called partial seizure with secondarily generalization.
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