CLTM Only Exam Material - Rebecca ClarkBash Study Guide actual exam questions and answers

In a patient with epileposy, which region of focus (by lobe of the brain) is known to have the greatest incidence of NORMAL EEG? Frontal Lobe Seizures from here don't always show up on the EEG Catamenial Epilepsy - What is it? Includes women whose seizures are exacerbated by their menstrual cycle. Women with catamenial epilepsy are unusually sensitive to endogenous hormonal changes. This seizure exacerbation has a statistically significant positive correlation to serum estradiol/estrogen levels and ratios. GAMMA A gamma wave is a pattern of neural oscillation in humans with a frequency between ___ and ___ Hz, though ___ Hz is typical. (Related to depth of anesthesia (patient state index) A gamma wave is a pattern of neural oscillation in humans with a frequency between 25 and 100 Hz, though 40 is typical. What is the most common artery that infarction, emboli, ischemia, thrombosis, etc., may be seen at? Middle Cerebral Artery (MCA) What are the most common symptoms of Middle Cerebral Artery cerebral infarction? Contralateral face and arm/hand paralysis C3 & C4 Arm/Hand Paralysis? Face Paralysis? Arm/Hand Paralysis T3 & T4 Arm/Hand Paralysis? Face Paralysis? Face Paralysis What is Compressed Spectral Array (CSA)? Three dimensional display of EEG power spectral lines. What is Spectral Edge Frequency (SEF)? Highest significant frequency present in the recorded EEG spectrum for each epoch. On the CSA, the Y Axis displays EEG as: Frequency in Hz OR Power as a function (amplitude or mV) Power as a function (amplitude or mV) On the CSA, the X Axis displays EEG as: Frequency in Hz OR Power as a function (amplitude or mV) Frequency in Hz Where does the burst-suppression pattern come from in the brain? Brainstem Only patients with what types of seizures qualify to have epilepsy surgery? Partial or Focal Epilepsies The WADA is also known as: Sodium Amobarbital Test The Sodium Amobarbital Test is hemisphere dominant for __________ & _____ _____ ____ assessment. Language & Short Term Memory NOT LONG TERM MEMORY OR SPEECH What does the WADA process begin with? It begins with selective angiography What is Angiography? Assesses arterial blood flow Selective Angiography is a procedure in which visualization is improved by concentrating the contrast media in the region to be studied by injection through a catheter. The Ambobarbital Sodium is injected via an arterial catheter which is located at the ______________. Proximal Internal Carotid Artery OR Proximal External Carotid Artery Proximal Internal Carotid Artery What kind of EEG activity would you see during a WADA? Slow activity (delta) in the hemisphere ipsilateral to the injection. **Ipsilateral hemispheric dysfunction & transient contralateral paralysis Excessive irrigation fluid of CSF in the field has which of the following influences on the recording? a. sixty cycle artifact b. shunting with subsequent cancellation c. no change d. all channels record the same activity in frequency & amplitude b. shunting with subsequent cancellation Almost like a big salt bridge Epilepsy Surgery: Amplifier Settings Sens _______ High Filter ______ Low Filter ______ 60 Cycle Filter On/Off Sens. 70-100 mV High Filter 150Hz Low Filter 1 Hz 60 Cycle Filter: OFF _________ Stimulatin used to elicit After Discharges to identify Epileptic Focus (seizure focus). Bipolar Biphasic What does Bipolar mean when it comes to Bipolar Biphasic Stimulation? Means the anode and cathode are very close together (within mm) *Means the current is applied from cathode to anode and then it switches back and forth Which function has the lowest risk of being affected if a temporal lobectomy is performed in the dominant hemisphere? Supplementary Motor Deficits During functional mapping, afterdischarges are more likely to occur with intensities greater than ____ mA. 10 mA Bipolar Biphasic Stimulation: Rate: Stim. Delivered for: Pulse Width: Stim. intensity: Range: Stim. duration: Rate: 40-60 pulses/sec Stim. Delivered for: 1-10 sec Pulse Width: 100-200 usec Stim. Intensity: 5-10 mA Range: 0-15 mA Stim. Duration: 0.1-0.3 ms _____________ are localized seizures and occur at an individual patient's threshold AFTER cortical stimulation. Afterdischarges If the EEG displays persistent epileptiform activity after direct cortical stimulation, what is the approach to stop the event? Cold irrigation The surgical treatment most beneficial for patients who have epileptic zones overlapping eloquent cortex: Multiple Subpial Transection Preferred treatment for Lennox-Gastaut syndrome. Multiple Subpial Transection OR Corpus Collostomy (Only if atonic seizures or drop attacks are mentioned) Surgical treatment for Rasmussens and Sturge Weber syndrome: Hemispherectomy If the diagnosis was Hypothalamic Hamartoma, what would be the surgery type? Gamma Knife (Gelastic Seizures) If the diagnosis was Rasmjussens Encephalitis, what would be the surgery type? Hemispherectomy If the diagnosis was Lennox-Gastaut with atonic seizures/drop attacks, what would be the surgery type? Corpus Collosotomy If the diagnosis was Sturge Weber Syndrome, what would be the associated surgery type? Hemispherectomy If the diagnosis was a patient with epileptic zones arising from or overlapping the eloquent cortex, what would be the surgery type? Multiple Subpial Transection If the diagnosis was Temporal Lobe Epilepsy, what would be the associated surgery type? Focal Resection Any catastrophic infant and early childhood epilepsies, what would be the associated surgery type? Hemispherectomy A bolus of Propofol or Pentobarbital will cause what change on the EEG? Burst-Suppression Phenobarbital will cause what change to the EEG? Beta Activity Anesthetics which end in "ANE" radically affect ___________. (N20 & P22) What happens to N20? Sensorimotor Strip Mapping Causes loss of N20 Agent Category: Inhalational Agents Isoflurane-Forane MAC: Sevoflurane-Altane MAC: Desflurane-Suprane MAC: 1.15% 2.2%