ABRET Neurological Disorders Ultimate Exam
Question 1. **Which ILAE 2017 classification term best describes a seizure that begins with impaired
awareness and evolves into rhythmic jerking of the limbs?**
A) Focal onset aware motor seizure
B) Focal onset impaired awareness motor seizure
C) Generalized onset tonic-clonic seizure
D) Unknown onset motor seizure
Answer: B
Explanation: The ILAE 2017 system classifies seizures that start with impaired awareness in the focal
onset category; when they progress to rhythmic limb jerks they are labeled focal onset impaired
awareness motor seizures.
---
Question 2. **In Benign Epilepsy with Centrotemporal Spikes (BECTS), the characteristic EEG
abnormality is most prominent during which state?**
A) Wakefulness
B) Light sleep (stage N2)
C) Deep sleep (stage N3)
D) REM sleep
Answer: C
Explanation: BECTS shows centrotemporal spikes that are maximal during slow-wave sleep (stage N3),
often disappearing in wakefulness.
---
Question 3. **Which of the following seizure types is most strongly associated with a photoparoxysmal
response on EEG?**
A) Absence seizures in CAE
B) Myoclonic jerks in JME
C) Focal seizures with autonomic symptoms
, ABRET Neurological Disorders Ultimate Exam
D) Atonic seizures in LGS
Answer: B
Explanation: Juvenile Myoclonic Epilepsy frequently demonstrates a photoparoxysmal response, i.e.,
generalized spike-and-wave bursts triggered by intermittent photic stimulation.
---
Question 4. **A 7-year-old child presents with frequent staring spells that are provoked by
hyperventilation. The EEG shows a 3 Hz spike-and-wave pattern. Which diagnosis is most likely?**
A) Juvenile Myoclonic Epilepsy
B) Childhood Absence Epilepsy
C) Lennox-Gastaut Syndrome
D) West Syndrome
Answer: B
Explanation: Childhood Absence Epilepsy is defined by brief, generalized absence seizures, a 3 Hz
spike-and-wave EEG, and a hyperventilation trigger.
---
Question 5. **In Lennox-Gastaut Syndrome, the typical interictal EEG pattern is:**
A) 3 Hz generalized spike-and-wave
B) 1.5-2.5 Hz slow spike-and-wave complexes
C) Hypsarrhythmia
D) Focal centrotemporal spikes
Answer: B
Explanation: LGS is characterized by a slow spike-and-wave discharge at 1.5-2.5 Hz, often accompanied
by multiple seizure types.
---
, ABRET Neurological Disorders Ultimate Exam
Question 6. **Which EEG finding is most characteristic of West Syndrome (Infantile Spasms)?**
A) Periodic lateralized epileptiform discharges (PLEDS)
B) Hypsarrhythmia
C) Triphasic waves
D) Alpha coma pattern
Answer: B
Explanation: Hypsarrhythmia, a chaotic high-voltage pattern with multifocal spikes, is the hallmark
interictal EEG of West Syndrome.
---
Question 7. **The EEG hallmark of non-convulsive status epilepticus (NCSE) is:**
A) Continuous generalized rhythmic delta activity for >10 seconds
B) Intermittent bursts of spikes with a background of normal alpha
C) Persistent focal or generalized rhythmic activity that evolves in frequency or morphology for
≥10 minutes
D) Isolated sharp transients without evolution
Answer: C
Explanation: NCSE is defined by an evolving rhythmic pattern (focal or generalized) that lasts at least
10 minutes, often with subtle clinical changes.
---
Question 8. **Which of the following is a typical EEG change seen in acute ischemic stroke affecting the
middle cerebral artery (MCA) territory?**
A) Generalized 3 Hz spike-and-wave activity
B) Focal delta slowing over the affected hemisphere
C) Bilateral symmetric alpha attenuation
D) Periodic lateralized epileptiform discharges (PLEDS) over the occipital lobes
Answer: B
, ABRET Neurological Disorders Ultimate Exam
Explanation: Acute MCA infarction produces focal slowing (delta) over the ischemic cortex due to loss of
fast frequencies.
---
Question 9. **In a patient with a posterior cerebral artery (PCA) infarct, the EEG most likely shows
slowing in which region?**
A) Frontal leads (Fp1-Fp2)
B) Temporal–parietal leads (T5-T6)
C) Occipital leads (O1-O2)
D) Central leads (C3-C4)
Answer: C
Explanation: PCA strokes affect the occipital lobe, so EEG slowing is most prominent in occipital leads.
---
Question 10. **Which EEG pattern is most closely associated with the development of vasospasm after
subarachnoid hemorrhage?**
A) Burst suppression
B) Generalized periodic discharges (GPDs)
C) Focal rhythmic delta activity (FRDA) over the affected vascular territory
D) Continuous alpha activity
Answer: C
Explanation: Vasospasm can produce focal rhythmic delta activity over the region supplied by the spastic
artery, reflecting cortical irritation.
---
Question 11. **A 55-year-old with severe hepatic failure shows a triphasic wave pattern on EEG. What
does this pattern indicate?**
Question 1. **Which ILAE 2017 classification term best describes a seizure that begins with impaired
awareness and evolves into rhythmic jerking of the limbs?**
A) Focal onset aware motor seizure
B) Focal onset impaired awareness motor seizure
C) Generalized onset tonic-clonic seizure
D) Unknown onset motor seizure
Answer: B
Explanation: The ILAE 2017 system classifies seizures that start with impaired awareness in the focal
onset category; when they progress to rhythmic limb jerks they are labeled focal onset impaired
awareness motor seizures.
---
Question 2. **In Benign Epilepsy with Centrotemporal Spikes (BECTS), the characteristic EEG
abnormality is most prominent during which state?**
A) Wakefulness
B) Light sleep (stage N2)
C) Deep sleep (stage N3)
D) REM sleep
Answer: C
Explanation: BECTS shows centrotemporal spikes that are maximal during slow-wave sleep (stage N3),
often disappearing in wakefulness.
---
Question 3. **Which of the following seizure types is most strongly associated with a photoparoxysmal
response on EEG?**
A) Absence seizures in CAE
B) Myoclonic jerks in JME
C) Focal seizures with autonomic symptoms
, ABRET Neurological Disorders Ultimate Exam
D) Atonic seizures in LGS
Answer: B
Explanation: Juvenile Myoclonic Epilepsy frequently demonstrates a photoparoxysmal response, i.e.,
generalized spike-and-wave bursts triggered by intermittent photic stimulation.
---
Question 4. **A 7-year-old child presents with frequent staring spells that are provoked by
hyperventilation. The EEG shows a 3 Hz spike-and-wave pattern. Which diagnosis is most likely?**
A) Juvenile Myoclonic Epilepsy
B) Childhood Absence Epilepsy
C) Lennox-Gastaut Syndrome
D) West Syndrome
Answer: B
Explanation: Childhood Absence Epilepsy is defined by brief, generalized absence seizures, a 3 Hz
spike-and-wave EEG, and a hyperventilation trigger.
---
Question 5. **In Lennox-Gastaut Syndrome, the typical interictal EEG pattern is:**
A) 3 Hz generalized spike-and-wave
B) 1.5-2.5 Hz slow spike-and-wave complexes
C) Hypsarrhythmia
D) Focal centrotemporal spikes
Answer: B
Explanation: LGS is characterized by a slow spike-and-wave discharge at 1.5-2.5 Hz, often accompanied
by multiple seizure types.
---
, ABRET Neurological Disorders Ultimate Exam
Question 6. **Which EEG finding is most characteristic of West Syndrome (Infantile Spasms)?**
A) Periodic lateralized epileptiform discharges (PLEDS)
B) Hypsarrhythmia
C) Triphasic waves
D) Alpha coma pattern
Answer: B
Explanation: Hypsarrhythmia, a chaotic high-voltage pattern with multifocal spikes, is the hallmark
interictal EEG of West Syndrome.
---
Question 7. **The EEG hallmark of non-convulsive status epilepticus (NCSE) is:**
A) Continuous generalized rhythmic delta activity for >10 seconds
B) Intermittent bursts of spikes with a background of normal alpha
C) Persistent focal or generalized rhythmic activity that evolves in frequency or morphology for
≥10 minutes
D) Isolated sharp transients without evolution
Answer: C
Explanation: NCSE is defined by an evolving rhythmic pattern (focal or generalized) that lasts at least
10 minutes, often with subtle clinical changes.
---
Question 8. **Which of the following is a typical EEG change seen in acute ischemic stroke affecting the
middle cerebral artery (MCA) territory?**
A) Generalized 3 Hz spike-and-wave activity
B) Focal delta slowing over the affected hemisphere
C) Bilateral symmetric alpha attenuation
D) Periodic lateralized epileptiform discharges (PLEDS) over the occipital lobes
Answer: B
, ABRET Neurological Disorders Ultimate Exam
Explanation: Acute MCA infarction produces focal slowing (delta) over the ischemic cortex due to loss of
fast frequencies.
---
Question 9. **In a patient with a posterior cerebral artery (PCA) infarct, the EEG most likely shows
slowing in which region?**
A) Frontal leads (Fp1-Fp2)
B) Temporal–parietal leads (T5-T6)
C) Occipital leads (O1-O2)
D) Central leads (C3-C4)
Answer: C
Explanation: PCA strokes affect the occipital lobe, so EEG slowing is most prominent in occipital leads.
---
Question 10. **Which EEG pattern is most closely associated with the development of vasospasm after
subarachnoid hemorrhage?**
A) Burst suppression
B) Generalized periodic discharges (GPDs)
C) Focal rhythmic delta activity (FRDA) over the affected vascular territory
D) Continuous alpha activity
Answer: C
Explanation: Vasospasm can produce focal rhythmic delta activity over the region supplied by the spastic
artery, reflecting cortical irritation.
---
Question 11. **A 55-year-old with severe hepatic failure shows a triphasic wave pattern on EEG. What
does this pattern indicate?**
