ABFM & KSA Seizures Certification Exam 2026/2027 Questions and
Answers 100% PASS
1. According to the International League Against Epilepsy (ILAE), what is the
clinical definition of epilepsy?
A. A single unprovoked seizure with no risk of recurrence
B. At least two unprovoked seizures occurring more than 24 hours apart
C. Any seizure activity lasting longer than 5 minutes
D. Provoked seizures occurring in the setting of acute illness
Answer: B
Rationale: Epilepsy is defined as at least two unprovoked seizures occurring >24 hours
apart, or one unprovoked seizure with a high probability of further seizures (at least 60%)
over the next 10 years.
2. Which of the following is the preferred first-line imaging modality for an adult
with a first-time non-emergent unprovoked seizure?
A. CT Scan of the head without contrast
B. MRI of the brain with epilepsy protocol
C. PET scan
D. Skull X-ray
Answer: B
Rationale: MRI is more sensitive than CT for identifying structural abnormalities like
mesial temporal sclerosis, small tumors, or cortical dysplasia which can be epileptogenic.
,3. What is the first-line pharmacological treatment for an adult in active status
epilepticus (seizure >5 minutes)?
A. Phenytoin infusion
B. Levetiracetam bolus
C. Lorazepam IV
D. Valproate IV
Answer: C
Rationale: Benzodiazepines, specifically IV Lorazepam, are the first-line treatment for
emergent termination of status epilepticus.
4. A 24-year-old female with generalized tonic-clonic seizures is planning a
pregnancy. Which of the following anti-epileptic drugs (AEDs) is associated with
the highest risk of major congenital malformations?
A. Levetiracetam
B. Lamotrigine
C. Valproate
D. Ethosuximide
Answer: C
Rationale: Valproate is highly teratogenic, associated with neural tube defects and lower
IQ scores in offspring, and should be avoided in women of childbearing age if possible.
5. Which EEG finding is classic for childhood absence epilepsy?
A. Hypsarrhythmia
B. 3 Hz spike-and-wave complexes
C. Temporal lobe spikes
D. Generalized polyspikes
Answer: B
Rationale: The classic EEG signature for absence seizures is a generalized 3 Hz spike-and-
wave pattern.
, 6. What distinguishes a ‘focal aware seizure’ from a ‘focal impaired awareness
seizure’?
A. The presence of motor activity
B. The duration of the seizure
C. Preservation of consciousness and memory during the event
D. The presence of a post-ictal state
Answer: C
Rationale: Focal aware seizures (formerly simple partial) occur with intact consciousness,
while focal impaired awareness seizures (formerly complex partial) involve loss of
awareness.
7. Which of the following side effects is most uniquely associated with long-
term Phenytoin use?
A. Weight gain
B. Gingival hyperplasia
C. Kidney stones
D. Aplastic anemia
Answer: B
Rationale: Phenytoin is well known for causing gingival hyperplasia, hirsutism, and
coarsening of facial features with chronic use.
8. A 7-year-old child presents with brief staring spells and lip-smacking. What is
the most likely seizure type?
A. Generalized tonic-clonic
B. Myoclonic seizure
C. Absence seizure
D. Atonic seizure
Answer: C
Answers 100% PASS
1. According to the International League Against Epilepsy (ILAE), what is the
clinical definition of epilepsy?
A. A single unprovoked seizure with no risk of recurrence
B. At least two unprovoked seizures occurring more than 24 hours apart
C. Any seizure activity lasting longer than 5 minutes
D. Provoked seizures occurring in the setting of acute illness
Answer: B
Rationale: Epilepsy is defined as at least two unprovoked seizures occurring >24 hours
apart, or one unprovoked seizure with a high probability of further seizures (at least 60%)
over the next 10 years.
2. Which of the following is the preferred first-line imaging modality for an adult
with a first-time non-emergent unprovoked seizure?
A. CT Scan of the head without contrast
B. MRI of the brain with epilepsy protocol
C. PET scan
D. Skull X-ray
Answer: B
Rationale: MRI is more sensitive than CT for identifying structural abnormalities like
mesial temporal sclerosis, small tumors, or cortical dysplasia which can be epileptogenic.
,3. What is the first-line pharmacological treatment for an adult in active status
epilepticus (seizure >5 minutes)?
A. Phenytoin infusion
B. Levetiracetam bolus
C. Lorazepam IV
D. Valproate IV
Answer: C
Rationale: Benzodiazepines, specifically IV Lorazepam, are the first-line treatment for
emergent termination of status epilepticus.
4. A 24-year-old female with generalized tonic-clonic seizures is planning a
pregnancy. Which of the following anti-epileptic drugs (AEDs) is associated with
the highest risk of major congenital malformations?
A. Levetiracetam
B. Lamotrigine
C. Valproate
D. Ethosuximide
Answer: C
Rationale: Valproate is highly teratogenic, associated with neural tube defects and lower
IQ scores in offspring, and should be avoided in women of childbearing age if possible.
5. Which EEG finding is classic for childhood absence epilepsy?
A. Hypsarrhythmia
B. 3 Hz spike-and-wave complexes
C. Temporal lobe spikes
D. Generalized polyspikes
Answer: B
Rationale: The classic EEG signature for absence seizures is a generalized 3 Hz spike-and-
wave pattern.
, 6. What distinguishes a ‘focal aware seizure’ from a ‘focal impaired awareness
seizure’?
A. The presence of motor activity
B. The duration of the seizure
C. Preservation of consciousness and memory during the event
D. The presence of a post-ictal state
Answer: C
Rationale: Focal aware seizures (formerly simple partial) occur with intact consciousness,
while focal impaired awareness seizures (formerly complex partial) involve loss of
awareness.
7. Which of the following side effects is most uniquely associated with long-
term Phenytoin use?
A. Weight gain
B. Gingival hyperplasia
C. Kidney stones
D. Aplastic anemia
Answer: B
Rationale: Phenytoin is well known for causing gingival hyperplasia, hirsutism, and
coarsening of facial features with chronic use.
8. A 7-year-old child presents with brief staring spells and lip-smacking. What is
the most likely seizure type?
A. Generalized tonic-clonic
B. Myoclonic seizure
C. Absence seizure
D. Atonic seizure
Answer: C
