[MCQ] Seizures and Epilepsy- Part 5

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Seizures and Epilepsy- Part 5

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Question 1

Which of the following medications increase  activity in EEG ?

A	Barbiturates
B	Benzodiazepines
C	Chloral hydrate
D	All of the above

Question 1 Explanation:

Beta activity is a fast rhythm of 13 per second and greater, is visualized on the EEG as a “jitteriness” of the trace. Barbiturates, benzodiazepines and chloral hydrate increase beta activity

Question 2

In EEG, which of the following signifies an encephalopathy ?

A	Localized slow frequency
B	Localized fast frequency
C	Diffuse slow frequency
D	Diffuse fast frequency

Question 2 Explanation:

Alterations of brain function results in abnormal slow frequency activity in EEG. Diffuse slow activity signifies an encephalopathy.

Question 3

In EEG, which of the following suggest epileptiform activity ?

A	Spikes
B	Sharp waves
C	Spike-wave complexes
D	Any of the above

Question 3 Explanation:

Epileptiform activity characteristic of epilepsy includes spikes, sharp waves and spike-wave complexes.

Question 4

Each EEG electrode can detect synchronous activity generated by how much area of surface cerebral cortex ?

A	~ 3 sq. cm.
B	~ 6 sq. cm.
C	~ 9 sq. cm.
D	~ 12 sq. cm.

Question 4 Explanation:

Each EEG electrode can detect synchronous activity generated by ~ 6 sq. cm. of cortex.

Question 5

Usually, EEG is performed after how many hours after a seizure episode ?

A	6 hours
B	12 hours
C	24 hours
D	48 hours

Question 6

EEG should include recordings during ?

A	Sleep
B	Photic stimulation
C	Hyperventilation
D	All of the above

Question 6 Explanation:

It is customary to perform EEG 48 hours or more after a suspected seizure, because EEG shortly after a seizure may give misleading findings. To provoke abnormalities, EEG should be recorded during sleep, sleep deprivation, photic stimulation, and hyperventilation (Activating procedures).

Question 7

Which of the following about EEG is false ?

A	Presence of epileptiform activity is not specific for epilepsy
B	In epileptic, initial interictal EEG is normal in ~ 60%
C	A normal EEG implies a better prognosis
D	None of the above

Question 8

Which of the following is useful in the evaluation of a patient with epilepsy ?

A	FLAIR
B	SPECT
C	PET
D	All of the above

Question 8 Explanation:

FLAIR has increased sensitivity for detection of abnormalities of cortical architecture. Positron emission tomography (PET) & single photon emission computed tomography (SPECT) are used to evaluate patients with medically refractory seizures

Question 9

FLAIR stands for ?

A	Fluid-attenuated inversion radiation
B	Fluid-augmented inversion radiography
C	Fluid-attenuated inversion radiography
D	Fluid-attenuated inversion recovery

Question 10

Electrocerebral silence is observed in ?

A	Irreversible brain damage
B	Hypothermia
C	Drug overdose
D	All of the above

Question 10 Explanation:

In electrocerebral silence, there is a reduction in amplitude of EEG until activity cannot be detected. It happens in irreversible brain damage, hypothermic patients or with drug overdose.

Question 11

In visual evoked potentials (VEPs), the component of major clinical importance is ?

A	P100 response
B	P200 response
C	P300 response
D	P400 response

Question 11 Explanation:

Visual evoked potentials (VEPs) are elicited by monocular stimulation with a reversing checkerboard pattern and are recorded from the occipital region in the midline and on either side of scalp. The component of major clinical importance is P100 response, a positive peak having a latency of approximately 100 ms

Question 12

VEPs are most useful in detecting dysfunction of visual pathways at the level ?

A	Anterior to optic chiasm
B	Optic chiasm
C	Optic radiation
D	Visual cortex

Question 12 Explanation:

VEPs are most useful in detecting dysfunction of the visual pathways anterior to the optic chiasm. In acute severe optic neuritis, P100 is frequently lost or grossly attenuated and as clinical recovery occurs and visual acuity improves, P100 is restored. VEP findings are helpful in indicating previous or subclinical optic neuritis. In cortical blindness, VEPs may be normal. Multifocal VEP is likely to be more sensitive than routine VEP.

Question 13

Factors associated with a high risk of recurrent seizures include all except ?

A	Known structural lesion
B	EEG abnormalities
C	Onset of seizure disorder during childhood
D	Seizures that require more than one antiepileptic drug

Question 14

Which of the following statements is false about EEG ?

A	Normal EEG shows posteriorly situated 8-13 Hz  rhythm
B	Alpha rhythm attenuates with eye opening
C	Right-sided placements are indicated by even numbers, leftsided placements by odd numbers
D	Midline placements are indicated by M

Question 14 Explanation:

Right-sided electrode placements are indicated by even numbers, left-sided placements by odd numbers, and midline placements by Z.

Question 15

Delta activity in EEG is seen in which stage of Hepatic Encephalopathy ?

A	Stage I
B	Stage II
C	Stage III
D	Stage IV

Question 15 Explanation:

Hepatic encephalopathy is associated with triphasic waves

Question 16

In EEG, periodic lateralized epileptiform discharges (PLEDs) is typical of ?

A	Subacute sclerosing panencephalitis (SSPE)
B	Herpes simplex encephalitis
C	Jakob-Creutzfeldt disease
D	Hepatic encephalopathy

Question 16 Explanation:

In EEG, periodic lateralized epileptiform discharges (PLEDs) is typical of herpes simplex encephalitis.

Question 17

The specific order of electrode pairs is called ?

A	Montage
B	Prelage
C	Consure
D	Primark

Question 17 Explanation:

The specific order of electrode pairs is called a montage.

Question 18

Which of the following statements about therapeutic range of antiepileptic drugs is false ?

A	Carbamazepine 15 - 20 μg/ml
B	Valproic acid 50 - 150 μg/ml
C	Phenytoin 10 - 20 μg/ml
D	Phenobarbital 10 - 40 μg/ml

Question 18 Explanation:

Therapeutic range of Carbamazepine is 4–12 μg/ml. Ethosuximide 40–120 μg/ml, Primidone 5–12 μg/ ml. Therapeutic range for Gabapentin, Lamotrigine, Levetiracetam, Oxcarbazepine is not established

Question 19

Estimation of which of the following helps to distinguish between organic and psychogenic seizures ?

A	Serum insulin levels
B	Serum growth hormone levels
C	Serum prolactin levels
D	Serum vasopressin levels

Question 19 Explanation:

Most generalized seizures and many complex partial seizures are accompanied by rises in serum prolactin during the immediate 30 minute postictal period, whereas psychogenic seizures are not. Peripheral WBC count also increase significantly after a generalized seizure.

Question 20

“Reflex epilepsy” best relates to ?

A	Alcohol intake
B	Sleep deprivation
C	Specific music or an individual’s voice
D	Physical exertion

Question 20 Explanation:

Seizures that are induced by highly specific stimuli such as a video game monitor, music, or an individual’s voice are categorized as “reflex epilepsy”.

Question 21

Risk factors associated with recurrent seizures include ?

A	Abnormal neurologic examination
B	Seizures presenting as status epilepticus
C	Abnormal EEG
D	All of the above

Question 21 Explanation:

Risk factors associated with recurrent seizures include an abnormal neurologic examination, seizures presenting as status epilepticus, postictal Todd’s paralysis, strong family history of seizures, an abnormal EEG.

Question 22

Which of the following is the first-line medication in focal seizures ?

A	Valproic acid
B	Lamotrigine
C	Carbamazepine
D	Ethosuximide

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See all quizzes of Seizures and Epilepsy at here:

1 Which of the following medications increase  activity in EEG ?
A. Barbiturates
B. Benzodiazepines
C. Chloral hydrate
D. All of the above

2 In EEG, which of the following signifies an encephalopathy ?
A. Localized slow frequency
B. Localized fast frequency
C. Diffuse slow frequency
D. Diffuse fast frequency

3 In EEG, which of the following suggest epileptiform activity ?
A. Spikes
B. Sharp waves
C. Spike-wave complexes
D. Any of the above

4 Each EEG electrode can detect synchronous activity generated by
how much area of surface cerebral cortex ?
A. ~ 3 sq. cm.
B. ~ 6 sq. cm.
C. ~ 9 sq. cm.
D. ~ 12 sq. cm.

5 Usually, EEG is performed after how many hours after a seizure
episode ?
A. 6 hours
B. 12 hours
C. 24 hours
D. 48 hours
6 EEG should include recordings during ?
A. Sleep
B. Photic stimulation
C. Hyperventilation
D. All of the above

7 Which of the following about EEG is false ?
A. Presence of epileptiform activity is not specific for epilepsy
B. In epileptic, initial interictal EEG is normal in ~ 60%
C. A normal EEG implies a better prognosis
D. None of the above
8 Which of the following is useful in the evaluation of a patient with
epilepsy ?
A. FLAIR
B. SPECT
C. PET
D. All of the above

9 FLAIR stands for ?
A. Fluid-attenuated inversion radiation
B. Fluid-augmented inversion radiography
C. Fluid-attenuated inversion radiography
D. Fluid-attenuated inversion recovery
10 Electrocerebral silence is observed in ?
A. Irreversible brain damage
B. Hypothermia
C. Drug overdose
D. All of the above

11 In visual evoked potentials (VEPs), the component of major
clinical importance is ?
A. P100 response
B. P200 response
C. P300 response
D. P400 response

12VEPs are most useful in detecting dysfunction of visual pathways
at the level ?
A. Anterior to optic chiasm
B. Optic chiasm
C. Optic radiation
D. Visual cortex

13 Factors associated with a high risk of recurrent seizures include
all except ?
A. Known structural lesion
B. EEG abnormalities
C. Onset of seizure disorder during childhood
D. Seizures that require more than one antiepileptic drug
14 Which of the following statements is false about EEG ?
A. Normal EEG shows posteriorly situated 8-13 Hz  rhythm
B. Alpha rhythm attenuates with eye opening
C. Right-sided placements are indicated by even numbers, leftsided
placements by odd numbers
D. Midline placements are indicated by M

15 Delta activity in EEG is seen in which stage of Hepatic
Encephalopathy ?
A. Stage I
B. Stage II
C. Stage III
D. Stage IV

16 In EEG, periodic lateralized epileptiform discharges (PLEDs) is
typical of ?
A. Subacute sclerosing panencephalitis (SSPE)
B. Herpes simplex encephalitis
C. Jakob-Creutzfeldt disease
D. Hepatic encephalopathy

17 The specific order of electrode pairs is called ?
A. Montage
B. Prelage
C. Consure
D. Primark
18 Which of the following statements about therapeutic range of
antiepileptic drugs is false ?
A. Carbamazepine 15 – 20 μg/ml
B. Valproic acid 50 – 150 μg/ml
C. Phenytoin 10 – 20 μg/ml
D. Phenobarbital 10 – 40 μg/ml

19 Estimation of which of the following helps to distinguish between
organic and psychogenic seizures ?
A. Serum insulin levels
B. Serum growth hormone levels
C. Serum prolactin levels
D. Serum vasopressin levels

20 “Reflex epilepsy” best relates to ?
A. Alcohol intake
B. Sleep deprivation
C. Specific music or an individual’s voice
D. Physical exertion

21 Risk factors associated with recurrent seizures include ?
A. Abnormal neurologic examination
B. Seizures presenting as status epilepticus
C. Abnormal EEG
D. All of the above

22 Which of the following is the first-line medication in focal seizures ?
A. Valproic acid
B. Lamotrigine
C. Carbamazepine
D. Ethosuximide

Seizures and Epilepsy

[MCQ] Seizures and Epilepsy- Part 5

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Seizures and Epilepsy- Part 5

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