ELECTROCORTICOGRAPHY AND
FUNCTIONAL MAPPING FOR CLTM
BOARD PREP ACTUAL EXAM
QUESTIONS WITH DETAILED VERIFIED
ANSWERS ALREADY GRADED A+
"How does ECoG activity differ from scalp recorded EEG? (select all that apply)
-More sharply contoured morphology
-Lower amplitude when recording from the cortex directly
-Higher amplitude
-Onset decrement or attenuation usually not seen on scalp recordings because it is so low
amplitude it is not recorded through the scalp and skull - CORRECT ANSWER=> -More sharply
contoured morphology
-Higher amplitude
-Onset decrement or attenuation usually not seen on scalp recordings because it is so low
amplitude it is not recorded through the scalp and skull"
"During surgery for an aortic arch dissection, the SSEP's from the lower extremities remain
stable, EEG shows no change but there is a gradual loss of the SSEP and Tc-MEP from the left
arm. What is the most likely etiology?
a. Left side spinal cord injury
b. Right cortical injury
c. Right brainstem injury
d. Occlusion of the left subclavian artery - CORRECT ANSWER=> d. Occlusion of the left subclavian
artery"
"Which of the following modalities is LEAST useful to monitor during surgery for a vertebral
artery aneurysm?
a. Lower extremity SSEP
b. Brainstem auditory evoked potential
c. Surface EEG
d. Upper extremity SSEP - CORRECT ANSWER=> c. Surface EEG"
Page | 1
,"In the past many brainstem lesions were considered inoperable but with modern microsurgical
techniques combined with neurophysiological mapping, many lesions in this area are now
amenable to surgical intervention.
True or False? - CORRECT ANSWER=> True"
"How are afterdischarges stopped?
a. IV valium
b. General anesthesia
c. IV antiepileptic drugs
d. Irrigation using cold (4 degrees C) Ringer's applied directly to the cortex - CORRECT ANSWER=>
d. Irrigation using cold (4 degrees C) Ringer's applied directly to the cortex"
"Appropriate filter settings for ECoG are:
a. 0.5 Hz to 35 Hz
b. 0.5 Hz to 70 or 100 Hz
c. 5 Hz to 60 Hz
d. 1 Hz to 70 Hz - CORRECT ANSWER=> b. 0.5 Hz to 70 or 100 Hz"
"What is the clinical consequence of occluding the right jugular vein?
a. Right brainstem stroke
b. None of the choices are correct, blood may return through the left jugular vein
c. Right hemispheric stroke
d. Brainstem stroke - CORRECT ANSWER=> b. None of the choices are correct, blood may return
through the left jugular vein"
"One concern in using direct cortical stimulation in ECoG is the resultant kindling effect, and
increase in seizure frequency and spreading as well as lowering of seizure thresholds to
stimulation over recurrent days using indwelling grids and strips.
True or False? - CORRECT ANSWER=> False"
"Refractory epilepsy by definition is: (select all that apply)
-The patient must be uncontrolled for more than 10 years
-Time with uncontrolled seizures is greater than 1-2 years, sometimes less in children
-2-3 antiepileptic drugs in use with good compliance
-Greater than one seizure per month - CORRECT ANSWER=> -Time with uncontrolled seizures is
greater than 1-2 years, sometimes less in children
-2-3 antiepileptic drugs in use with good compliance
Page | 2
, -Greater than one seizure per month"
"Electrical stimulation of the cortex directly in ECoG leads to a positive or negative function
phenomenon.
True or False? - CORRECT ANSWER=> True"
"Select the statements that are true about language mapping. (select all that apply)
-Language tasks evaluated are counting and object naming
-When language cortex is stimulated, the patient will experience speech arrest (SA) or naming
error (N)
-It is crucial in patients with lesions in the dominant hemisphere
-The patient will experience accelerated speech during stimulation of language cortex
-Patients must always be anesthetized during language localization
-The patient must actively participate in language tasks as the cortex is stimulated in order to
evaluate the effects of cortical stimulation - CORRECT ANSWER=> -Language tasks evaluated are
counting and object naming
-When language cortex is stimulated, the patient will experience speech arrest (SA) or naming
error (N)
-It is crucial in patients with lesions in the dominant hemisphere
-The patient must actively participate in language tasks as the cortex is stimulated in order to
evaluate the effects of cortical stimulation"
"Phase I in the LTME Unit is to classify and quantify events including: (select all that apply)
-Characterize topography of seizures (lateralization, localization, and distribution)
-Precipitating circumstances or stimuli if any
-Quantify seizures and interictal activity
-Physical patient changes during the seizures
-Classify types of events or seizures for diagnosis
-Begin assessment of candidacy for epilepsy surgery - CORRECT ANSWER=> -Characterize
topography of seizures (lateralization, localization, and distribution)
-Precipitating circumstances or stimuli if any
-Quantify seizures and interictal activity
-Physical patient changes during the seizures
-Classify types of events or seizures for diagnosis
-Begin assessment of candidacy for epilepsy surgery"
"_________ can sometimes cause function to gradually shift locations into unexpected areas
creating a type of functional cortical dysplasia.
Page | 3
FUNCTIONAL MAPPING FOR CLTM
BOARD PREP ACTUAL EXAM
QUESTIONS WITH DETAILED VERIFIED
ANSWERS ALREADY GRADED A+
"How does ECoG activity differ from scalp recorded EEG? (select all that apply)
-More sharply contoured morphology
-Lower amplitude when recording from the cortex directly
-Higher amplitude
-Onset decrement or attenuation usually not seen on scalp recordings because it is so low
amplitude it is not recorded through the scalp and skull - CORRECT ANSWER=> -More sharply
contoured morphology
-Higher amplitude
-Onset decrement or attenuation usually not seen on scalp recordings because it is so low
amplitude it is not recorded through the scalp and skull"
"During surgery for an aortic arch dissection, the SSEP's from the lower extremities remain
stable, EEG shows no change but there is a gradual loss of the SSEP and Tc-MEP from the left
arm. What is the most likely etiology?
a. Left side spinal cord injury
b. Right cortical injury
c. Right brainstem injury
d. Occlusion of the left subclavian artery - CORRECT ANSWER=> d. Occlusion of the left subclavian
artery"
"Which of the following modalities is LEAST useful to monitor during surgery for a vertebral
artery aneurysm?
a. Lower extremity SSEP
b. Brainstem auditory evoked potential
c. Surface EEG
d. Upper extremity SSEP - CORRECT ANSWER=> c. Surface EEG"
Page | 1
,"In the past many brainstem lesions were considered inoperable but with modern microsurgical
techniques combined with neurophysiological mapping, many lesions in this area are now
amenable to surgical intervention.
True or False? - CORRECT ANSWER=> True"
"How are afterdischarges stopped?
a. IV valium
b. General anesthesia
c. IV antiepileptic drugs
d. Irrigation using cold (4 degrees C) Ringer's applied directly to the cortex - CORRECT ANSWER=>
d. Irrigation using cold (4 degrees C) Ringer's applied directly to the cortex"
"Appropriate filter settings for ECoG are:
a. 0.5 Hz to 35 Hz
b. 0.5 Hz to 70 or 100 Hz
c. 5 Hz to 60 Hz
d. 1 Hz to 70 Hz - CORRECT ANSWER=> b. 0.5 Hz to 70 or 100 Hz"
"What is the clinical consequence of occluding the right jugular vein?
a. Right brainstem stroke
b. None of the choices are correct, blood may return through the left jugular vein
c. Right hemispheric stroke
d. Brainstem stroke - CORRECT ANSWER=> b. None of the choices are correct, blood may return
through the left jugular vein"
"One concern in using direct cortical stimulation in ECoG is the resultant kindling effect, and
increase in seizure frequency and spreading as well as lowering of seizure thresholds to
stimulation over recurrent days using indwelling grids and strips.
True or False? - CORRECT ANSWER=> False"
"Refractory epilepsy by definition is: (select all that apply)
-The patient must be uncontrolled for more than 10 years
-Time with uncontrolled seizures is greater than 1-2 years, sometimes less in children
-2-3 antiepileptic drugs in use with good compliance
-Greater than one seizure per month - CORRECT ANSWER=> -Time with uncontrolled seizures is
greater than 1-2 years, sometimes less in children
-2-3 antiepileptic drugs in use with good compliance
Page | 2
, -Greater than one seizure per month"
"Electrical stimulation of the cortex directly in ECoG leads to a positive or negative function
phenomenon.
True or False? - CORRECT ANSWER=> True"
"Select the statements that are true about language mapping. (select all that apply)
-Language tasks evaluated are counting and object naming
-When language cortex is stimulated, the patient will experience speech arrest (SA) or naming
error (N)
-It is crucial in patients with lesions in the dominant hemisphere
-The patient will experience accelerated speech during stimulation of language cortex
-Patients must always be anesthetized during language localization
-The patient must actively participate in language tasks as the cortex is stimulated in order to
evaluate the effects of cortical stimulation - CORRECT ANSWER=> -Language tasks evaluated are
counting and object naming
-When language cortex is stimulated, the patient will experience speech arrest (SA) or naming
error (N)
-It is crucial in patients with lesions in the dominant hemisphere
-The patient must actively participate in language tasks as the cortex is stimulated in order to
evaluate the effects of cortical stimulation"
"Phase I in the LTME Unit is to classify and quantify events including: (select all that apply)
-Characterize topography of seizures (lateralization, localization, and distribution)
-Precipitating circumstances or stimuli if any
-Quantify seizures and interictal activity
-Physical patient changes during the seizures
-Classify types of events or seizures for diagnosis
-Begin assessment of candidacy for epilepsy surgery - CORRECT ANSWER=> -Characterize
topography of seizures (lateralization, localization, and distribution)
-Precipitating circumstances or stimuli if any
-Quantify seizures and interictal activity
-Physical patient changes during the seizures
-Classify types of events or seizures for diagnosis
-Begin assessment of candidacy for epilepsy surgery"
"_________ can sometimes cause function to gradually shift locations into unexpected areas
creating a type of functional cortical dysplasia.
Page | 3
