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The role of EEG in patients with suspected epilepsy Volume 22, numéro 2, April 2020

TEST YOURSELF

 

(1) Which is true regarding interictal epileptiform discharges (IEDs) on a routine EEG?

A. IEDs are present in over 90% of epilepsy patients

B. IEDs have no value in determining the type epilepsy

C. IEDs demonstrate high specificity in theory, but not in practice due to the common over-interpretation of normal variants

D. A normal routine EEG excludes the diagnosis of epilepsy

 

(2) In patients who are seizure-free on antiseizure medication (ASM), when considering withdrawal of the ASM:

A. EEG should not be recorded, because ASM can be withdrawn even when patients have IEDs.

B. EEG is an independent predictor, so risks can be assessed based on EEG alone.

C. EEG is useful only when considering withdrawing ASM in children.

D. EEG is useful only when considering withdrawing ASM in patients with focal epilepsy.

E. Presence of IEDs increases the risk of recurrence after ASM withdrawal, but this needs to be weighed together with the clinical data.

 

(3) Which is true of routine (standard) EEG for the diagnosis of epilepsy?

A. It is very sensitive.

B. It is poorly specific.

C. Errors in interpretation (over-reading) are common.

D. It typically requires two hours of recording.

 

(4) Which is false regarding prolonged video-EEG monitoring?

A. Provides a diagnosis in the majority of cases if the event in question is recorded.

B. Must be performed in the hospital.

C. Can record interictal epileptiform abnormalities even if no events are recorded.

D. Is an expensive procedure.

 

(5) EEG in the ICU:

A. Results is a precise diagnosis.

B. Provides an overview of the severity of an encephalopathy.

C. Is required for the diagnosis of brain death.

D. Is not affected by medications.

 

(6) The value of a prolonged ICU EEG relates to the fact that:

A. It can show trends in the underlying disease over time.

B. Once started, it requires little effort on the part of the technicians.

C. Requires no clinical information to interpret.

D. Recording artefact is easy to identify.

 

(7) Sedative medications during an ICU EEG:

A. Have a uniform effect on the EEG, independent of drugs.

B. Need only be noted as being used.

C. Should only be used to suppress seizures in status epilepticus.

D. May vary in effect based on dose, so changes must be identified.

 

(8) The EEG is reported as technically difficult if:

A. The patient does not fall asleep.

B. No events of interest occur.

C. Artefacts are present beyond the control of the technician such as lack of cooperation by the patient or an unfriendly electrical environment.

D. The recording contains artefacts that the technician fails to eliminate.

E. All of the above

 

(9) The description of epileptiform discharges in the EEG report:

A. Should avoid committing to a specific localization.

B. Should include location, frequency, relation to state, and provocation methods.

C. Should not be correlated with background abnormalities.

D. Should not use standardized terminology.

E. All of the above.

 

(10) A neonatal EEG:

A. Is not technically possible.

B. Should include only events of interest.

C. Should include the exact age including post presumed conception, and postnatal age and appropriate recording of sleep states.

D. Cannot be interpreted.

E. All of the above.

 

 

 

 

 

 

 

 

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Answers

(1) C.

 

(2) E.

 

(3) C.

 

(4) B.

 

(5) B.

 

(6) A.

 

(7) D.

 

(8) C.

 

(9) B.

 

(10) C.

 

 

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