EEG Questions and Answers for Epilepsy Diagnosis and Treatment, Exams of Nursing

Download EEG Questions and Answers for Epilepsy Diagnosis and Treatment and more Exams Nursing in PDF only on Docsity! EEG/CLTM QUESTIONS AND ANSWERS 2024 ALL CORRECT Where is the hippocampus located? - Correct answer Temporal lobe, responsible for learning and memory What is the amygdala responsible for? - Correct answer Long term emotional, processing of memory, the amygdalae are considered part of the limbic system. Located in Temporal Lobe Foramen Ovale Electrodes - Correct answer Used to diagnose mesial temporal lobe epilepsy without penetration of the skull. These are 1 to 4 contact flexible platinum wires inserted by needle thru the cheek in the ambient cistern with the help of an X-ray Todd's Paralysis - Correct answer Paralysis or weakness in a part of the body after a seizure. This weakness typically affects arms or legs, but may also affect speech, eye position or vision. usually subsides completely within 48 hours. Rasmussen's Encepholopathy - Correct answer Rare, chronic focal encephalitis, characterized by frequent severe seizures, loss of motor skills and speech, hemiparesis, and dementia. The illness affects a single cerebral hemisphere and generally occurs in children under the age of 15. SUDEP - Correct answer defined as the sudden and unexpected, non- traumatic and non-drowning death of a person with epilepsy without a known cause. Current CPR chest compressions - Correct answer 30 to 2, or 100 per minute for adults. And 15 to 2 for children Hip Thrusting - Correct answer #1 Characteristic of Non epileptic events Gelastic Seizures - Correct answer Are associated with several different conditions, but mainly hypothalamic hamartomas. Characterized by sudden outbursts of Laughter, crying or cough for no apparent or appropriate reason. Cataplexy - Correct answer A sudden and transient episode of muscle weakness, with full conscious awareness, typically triggered by emotions such as laughing, crying, terror, etc. It is the cardinal symptom of narcolepsy Frontal lobe - Correct answer complex automatisms arise from what lobe? Cortical Dysplasia - Correct answer A congenital abnormality where the neurons in an area of the brain failed to migrate in the proper formation in utero, commonly found near the cerebral cortex and is associated with seizures Lennox Gastaut - Correct answer Onset between age 2 & 6. characterized by frequent seizures of different types; is often accompanied by developmental delay, psychological and behavioral problems. About half of patients will have status. interictal EEG shows slow spike-wave complexes. Keppra - Correct answer Levetiracetam: used for partial seizures, or as an adjunctive therapy for partial, myoclonic and tonic-clonic seizures. Juvenile Myoclonic Epilepsy (JME) - Correct answer Seen in ages 12 to 18, brief involuntary muscle twitching in the morning. Most have generalized seizures, many also have absence seizures. Treated with Depakote (Valproic Acid). EEG shows generalized 3-4 Hz polyspike and slow wave discharges. Often provoked by Photic and HV Temporal Lobe Epilepsy - Correct answer Recurrent, unprovoked seizures which originate from the temporal lobe. Seizures involve sensory changes; such as smelling an unusual odor that is not there, or a memory disturbance. The most common cause is mesial temporal sclerosis. Surgery can be complicated by decreased cognitive function. Simple Partial Seizures - Correct answer Are seizures involving small areas of the temporal lobe such as the amygdala and hippocampus. There is no impairment to the level of consciousness. Ohtahara syndrome - Correct answer AKA Early Infantile Epileptic Encephalopathy with Burst-Suppression, an extremely debilitating progressive neurological disorder, involving intractable seizures and severe mental retardation. Angelman's Syndrome - Correct answer severe intellectual and developmental disability, sleep disturbance, seizures, jerky movements (especially hand-flapping), frequent laughter or smiling, and usually a happy demeanor. Seizure onset usually prior to age 3. EEG shows high amplitude slow-spike and wave. "Happy Puppet" Tuberous Sclerosis - Correct answer genetic disease in which benign tumors form in the brain and on other vital organs such as the kidneys, heart, eyes, lungs, and skin. A combination of symptoms may include seizures, intellectual disability, developmental delay, behavioral problems, skin abnormalities, lung and kidney disease. West's Syndrome - Correct answer Is the triad of infantile spasms, hypsarrhythmia, and developmental regression. Is treated with ACTH or Vigabatrin, EEG pattern best seen when patient is awake. Depakote - Correct answer Valproic Acid. Used to treat juvenile myoclonic epilepsy. Is most effective AED for generalized seizures, but has significant side effects Lamotrigine - Correct answer Lamictal - first line drug for primary generalized tonic-clonic seizures, including simple partial, complex partial and secondarily generalized seizures. Also used to treat Lennox Gaustaut. MSDS - Correct answer provides workers and emergency personnel info about safe handling or working with substances. This info includes physical data (melting point, boiling point, and flash point), toxicity, health effects, first aid, reactivity, storage, disposal, protective equipment, and spill- handling procedures ICP normal ranges - Correct answer ICP is normally 7-15 mm/Hg. 20-25 mm/Hg is considered high. and above 60 is deadly. Contracoup injury - Correct answer If a patient has a Right side injury but left side spikes, this may be caused by? Surgical resection - Correct answer Phase 3 of epilepsy surgery? Meyers Loop Damage - Correct answer Causes loss of vision, upper quadrantanopia, "pie in the sky" Surgical treatment for drop attacks - Correct answer Corpus Collosotomy, results in decrease in seizures. Arterial blood flow - Correct answer Angiography before WADA testing is used for? functional hemispherectomy - Correct answer Treatment for Rasmussen's, Sturge Weber, and hemimegaloenchephaly SUDEP risk factors - Correct answer number of AED's, mental retardation, tonic clonic seizures, and alcohol abuse. Has a higher frequency in men. Phases of LTM - Correct answer Phase 1. Is all non invasive -including sphenoidal electrodes. Phase 2. Is all invasive- subdermal, depth, or grid electrode placement. Phase 3. Is surgery A poor prognosis - Correct answer alpha coma carries a what kind of prognosis? At 2-7 months of age - Correct answer What is the age of onset for infantile spasms Sturge Weber - Correct answer Port wine stain or birthmark, loss of nerve cells, seizures begin in infancy, developmental delay Frontal lobe - Correct answer Hyperkinetic activity comes from ethmoidal electrodes - Correct answer inserted between the middle turbinate bone and nasal septum Heterotopia - Correct answer presence of normal cells in improper locations On a T1 weighted MRI - Correct answer gray matter is gray, white matter is white, CSF is black, Is used to asses brain morphology On a T2 weighted MRI - Correct answer gray is bright, CSF is white, Fat is dark, Is used to asses if tissue is abnormal hyperkyplexia - Correct answer disease with accentuation of startle response Akinetic seizure - Correct answer inability to perform or maintain voluntary movements Barbiturate - Correct answer What type of drug is Pentobarbital? If collodion gets in eyes - Correct answer flush with water, then seek medical attention what electrodes can be used in place of sphenoidals - Correct answer F9 and F10, used to monitor Mesial and Anterior Temporal senior citizens - Correct answer What demographic is most rapidly developing new onset seizures? Bilaterally absent corticals - Correct answer After 3 days post an anoxic injury, which median SEP outcome is the worst. At 15mm/Hg - Correct answer At what flow rate does blood flow cease? At 40mm/Hg or greater - Correct answer Intra cranial pressure affects EEG at what level? mesial temporal lobe epilepsy - Correct answer ECOG works best for patients with what type of epilepsy? Type: Motor, Moves eyes outward or laterally. Test by following finger. Glossopharyngeal - Correct answer Cranial Nerve 9, From: Medulla. Type: Both, Taste on back 1/3 of tongue, swallow, salivation, and carotid sinus. "Gag reflex" "say aahhh" Facial - Correct answer Cranial Nerve 7, From: Pons, Type: Both, Moves facial muscles, taste on front 2/3 of tongue, tears, and salivation, test by asking patient to smile. Vagus - Correct answer Cranial Nerve 10, From: Medulla, Type: Both, Taste, swallow, lift palate, talk, and stimulates digestion. Trochlear - Correct answer Cranial Nerve 4, From: Midbrain, Type: Motor, Moves eyes down and inward Oculomotor - Correct answer Cranial Nerve 3, From: Midbrain, Type: Motor, Moves eyes down and up, in and out, constricts pupils, and raises eye lids. Optic - Correct answer Cranial Nerve 2, From: Brain, Type: Sensory, Controls visual acuity Olfactory - Correct answer Cranial Nerve 1, From: Brain, Type: Sensory, Controls sense of smell Accessory - Correct answer Cranial Nerve 11, From: Medulla, Type: Motor, Turns head and lifts shoulders Acoustic Auditory / Vestibular Cochlear - Correct answer Cranial Nerve 8, From: Pons, Type: Sensory, Controls hearing and balance Hypoglossal - Correct answer Cranial Nerve 12, From: Medulla, Type: Motor, Moves tongue Trigeminal - Correct answer Cranial Nerve 5, From: Mostly Pons but also midbrain and spinal cord. Type: Both, Chewing muscles and sensation of face Brodmann's Areas 41 and 42 - Correct answer Primary auditory cortex. Contains Herschl's Gyri - the posterior half of the superior temporal gyrus Brodmann's Area 4 - Correct answer Motor Cortex Brodmann's Area 22 - Correct answer Superior temporal gyrus, part of which contains Wernicke's area. Is responsible for comprehension of speech. Lesions here would cause receptive aphasia Brodmann's Area 6 - Correct answer Premotor Cortex Brodmann's Area 10 - Correct answer Prefrontal Cortex, Responsible for personality and behavior Brodmann's Areas 44 and 45 - Correct answer Broca's area, Responsible for speech, Lesions here would cause expressive aphasia Brodmann's Areas 18 and 19 - Correct answer Visual association areas Brodmann's Area 17 - Correct answer Primary Visual Cortex Brodmann's Areas 1, 2, and 3 - Correct answer Somatosensory Cortex SPECT Scan - Correct answer Localized seizure for presurgical evaluation by use of an injected tracer which reveals increased blood flow during a seizure. Tracer should be injected prior to end of seizure. Helpful for diagnosis of pseudo seizures due to no increase in blood flow during event. Wernicke's Area - Correct answer Located in the temporal lobe. Is responsible for receptive speech. Damage here would cause receptive aphasia, unable to understand spoken words MEG scan - Correct answer Magnetoencephalography. Measures the magnetic fields generated by neuronal activity of the brain, and also brain function MRS scan - Correct answer Magnetic Resonance Spectroscopy. Used to study metabolic changes in brain tumors Reflex Epilepsies - Correct answer A group of epilepsies in which seizures are caused by a known stimuli. The most common is photosensitive seizures. Usually tonic clonic, but not always. Crutzfeldt-Jakob Disease - Correct answer Rare but fatal prion disorder which presents with cognitive changes, followed by behavioral changes, then myoclonic jerking, and finally severe dementia and death. EEG shows short bursts of diffuse sharps at a rate of 0.5 to 1 second Afferent - Correct answer Spinothalomic tract, is Assending, = sensory, SEP OR time out - Correct answer To identify patients name, date of birth, procedure, what side/location, and who's all in the room. Intermittent Rhythmic Delta Activity (IRDA) - Correct answer Is seen maximal over the frontal or occipital lobes and can be caused by various reasons, some benign or unknown, but also are commonly associated with lesions and tumors. Neuroleptic Malignant Syndrome - Correct answer A serious combination of autonomic disorder, hyperthermia, and rigidity that is a possible complication of antipsychotic drugs Classic Absence Seizure - Correct answer Aka petitmal seizure. Patient stares off into space, 3 per second spike and wave, HV can accentuate Syringomyelia - Correct answer Disorder in which a cyst called a syrinx forms in the spinal cord, over time destroying a portion of the cord due to its expansion Neurotransmitters - Correct answer Chemical agents released by a presynaptic cell upon excitation Central Sulcus, aka Rolandic Fissure - Correct answer Separates the frontal lobe from the parietal lobe Auditory Agnosia - Correct answer Inability to recognize or differentiate sounds. Not a deficit of the ear. An inability of the brain to process sounds. Caused by damage to the auditory cortex of temporal lobe. Brodmanns 41 & 42 Cisterns - Correct answer Areas where the brain doesn't closely contact the skull, creating a pocket. Most are found at the base of the brain Phantom Spikes - Correct answer Aka 6hz spike & wave. Less than 40uV and 1 second in duration. Occur during drowsiness or at rest with eyes closed. May also be activated by photic stimulation Oligodendrogliomas - Correct answer Slow growing solid or cystic tumors usually found in older patients in their 40s or 50s Stereotypies - Correct answer Seen in children, are repetitive movements such as finger tapping & hair curling. complex forms include shuddering attacks, rocking, & feet and leg movements. Are not associated with Tourette's Syndrome. Treatments are not needed or effective. Pallid breath hold spell - Correct answer Spell caused by a slowing of child's heart rate. Is usually in response to pain. Foramen - Correct answer Aka apertures. Openings in the brain that allow CSF to exit from the ventricles to diffuse around the brain and spinal cord Nodes of Ranvier - Correct answer Sections of myelin around the axon that allow potentials to leap faster from one to another. They look like a string of sausage links Ependyma - Correct answer Lines the ventricles and the central canal of the spinal cord, and secretes CSF Tardive Dyskinesia - Correct answer Neuro disorder which occurs as a result of long term or high dose use of antipsychotic neuroleptic drugs. Seen in children as side effect of drugs used for gastrointestinal disorders Hypsarrhythmia - Correct answer Abnormal chaotic pattern seen in infants, extremely high voltage, multiple sharps, spikes & slow waves, with burst suppression likely during sleep. Associated with infantile spasms. Functional MRI (fMRI) - Correct answer Measures changes in blood flow, associated with neural activity. Provides better resolution than SPECT scans Hyperemia - Correct answer Condition in which there is to much blood in the brain. Can cause increased ICP, and compress or damage brain tissue Anteriomedial Temporal Resection (AMTR) - Correct answer Most common type of epilepsy surgery. Used in cases of intractable temporal lobe seizures. Often in patients with Mesial temporal sclerosis Volumetrics - Correct answer High resolution MRI used to calculate the volume of a brain structure or mass. Anterograde Amnesia - Correct answer The inability to form or store new memories. Cyanotic Breath hold spell - Correct answer Caused by a change in child's normal breathing pattern, usually in response to feeling angry or frustrated. Is the most common of the two breath hold types. Schwann Cell - Correct answer Produces myelin in the peripheral nervous system Wernicke's Encephalopathy - Correct answer Disorder seen in alcoholics. Is due to a thiamine & vitamin B deficiency. Causes nystagmus, dimness of vision, ptosis, & ataxia with tremors. Oligodendrocytes - Correct answer A type of neuroglia who's function is to provide support and insulation to axons in the CNS by creating and maintaining the myelin sheath. Resting membrane potential - Correct answer Is -70 to -80mV, inside is negatively charged protein and high amounts of potassium. Outside has high amounts of sodium & chloride Tay-Sach's Disease - Correct answer Inherited lipid storage disease with exaggerated startle response, myoclonic jerks, blindness, & seizures. Usually fatal by age 3-5. EEG shows diffuse delta and spikes Minimum Alveolar Concentration, aka MAC - Correct answer The amount of anesthetic necessary to prevent movement in 50% of patients in response to surgical stimulation 14 & 6 positive spikes - Correct answer Seen during drowsiness and sleep in children. Are best seen in ear reference montage. Are most prominent in temporal and posterior regions Subacute Sclerosing Panencephalitis, Choroid Plexus - Correct answer A network of capillaries in the ventricles that produce CSF. These capillaries are surrounded by ependymal cells which help to maintain the blood CSF barrier, there by controlling CSF composition Precentral Gyrus, aka Motor Strip - Correct answer Is located in front of the central sulcus (Rolandic Fissure) at the back of the frontal lobe. Controls motor function to corresponding areas of the contralateral body Friedreich's Ataxia - Correct answer A life shortening genetic degenerative disorder, caused by gene mutations that limit the production of a protein called frataxin. Symptoms are ataxia, fatigue, vision impairment, hearing loss, slurred speech, scoliosis, diabetes, and an enlarged heart Phenylketonuria - Correct answer A disorder where amino acid builds up in the blood of babies. Is treated with a special diet. If untreated, can cause retardation and seizures Huntington's Chorea - Correct answer Degenerative disease with severe atrophy of the cortex, particularly in the frontal lobe. Causes quick, jerky, dance like movements. There is no cure, and death usually occurs about 15 years after onset. EEG shows low amplitude rhythms Foreman Magnum - Correct answer Large opening in the basal part of the occipital bone, through which the spinal cord becomes continuous with the medulla oblongata Basal Ganglia - Correct answer Gray matter located deep within each hemisphere, which controls involuntary movement, balance, posture, and muscle tone Tourette Syndrome - Correct answer Is any combo of verbal and motor tics, is part of a phenotypic spectrum that includes simple motor tics, ADD, and OCD. It's gene is transmitted as a highly penetrant, autosomal dominant trait Benign Epileptifom Transients of Sleep, aka BETS - Correct answer Low amplitude, negative polarity, "small sharp spikes", seen mostly in frontal temporal areas during drowsiness & sleep. Is a normal variant Rhythmic Mid-Temporal Discharges (RMTD) - Correct answer Aka psychomotor variant. Sharp waves seen in the mid temporal region, at a frequency of 4-6hz, flat topped or notched in appearance Arteriovenous Malformation, aka AVM - Correct answer A congenital abnormality where arteries lead directly to veins, without going through capillaries. Causing a tangled network of blood vessels Aqueduct of Sylvius - Correct answer The canal opening the connects the 3rd and 4th ventricles Carbamazepine - Correct answer Aka Tegretol. First line drug used for complex partial seizures. This will make absence seizures and myoclonic seizures worse Diazepam - Correct answer aka Valium. Used to treat Status Epilepticus, and Electrical Status Epilepticus during slow Sleep (ESES) Middle Cerebral Artery, aka MCA - Correct answer Provides blood to the lateral aspects of the frontal, parietal, and temporal lobes, as well as the basal ganglia. Blockage here would cause paralysis of arms & face on opposite side Xanthochromic - Correct answer The yellowish appearance of CSF in particular medical conditions, specially during a subarachnoid hemorrhage Atypical Absence Seizures - Correct answer aka Petitmal Variant Seizures. Consists of twitching and staring, with no impairment of consciousness. EEG shows generalized 1.5hz spike & wave What is Tonic phase? - Correct answer During a seizure, this is the straightening or stiffening of the body or limbs What is the clonic phase? - Correct answer This is the jerking of the body, head, and limbs during a seizure Comparisons of the 10 10 system vs. the 10 20 system - Correct answer F9 & F10 = T1 & T2, T7 & T8 = T3 & T4, and P7 & P8 = T5 & T6 T1 & T2 placement is? (F9 & F10) - Correct answer 1/3 the distance anteriorly, from the external auditory canal to the outer canthus of the eye, and up 1 centimeter. Can be used in place of sphenoidals Barbiturates are? - Correct answer A group of drugs that act as a depressant on the central nervous system. In high doses they act as an anesthetic. In low doses they are sleep inducing, they also have a hypnotic property Parkinson's Disease - Correct answer A slow progressing degenerative disease of the basal ganglia, due to a lack of dopamine. Causes tremors, stiffness, and balance problems. "Mask like face" Limbic System - Correct answer Supports behaviors related to survival, reproduction, memory, fear, and rage. But also the regulation of biological rhythms, sexual behavior, and motivation. Amygdala - Correct answer 2 almond shaped masses on either side of the thalamus, which deal with memory, emotion, and fear. Helps form and store memories related to emotional event Basilar Artery (BA) - Correct answer Supplies blood to the posterior region of the cerebrum. Blockage here would be considered a major stroke. Patient would be paralyzed bilaterally and in a coma Sphenoidal Electrodes - Correct answer Are fine flexible braided wires, inserted through the zygomatic arch, by a physician during a sterile procedure. They are used to record from the mesial or anterior aspects of the temporal lobe. Wickets - Correct answer A normal variant seen in both awake and in light sleep, with a frequency of 6-11Hz. They usually occur in short runs, but