ABRET EEG BOARD REVIEW 2026
200 HIGH YIELD EXAM QUESTIONS
AND ANSWERS RATIONALE AND
EXPLANATIONS INCLUDED
ABRET EEG Board Review Practice Exam (2026 Edition)
1. A 45-year-old patient with a history of intractable focal
epilepsy is undergoing an EEG using the International 10-20
system. During the recording, a rhythmic 6 Hz discharge is
noted in the mid-temporal region that does not evolve in
frequency or morphology and is not associated with any
clinical symptoms. What is the most likely interpretation of
this finding?
A) Ictal rhythmic mid-temporal discharge (IRMTD)
B) Rhythmic Mid-Temporal Theta of Drowsiness
(Psychomotor Variant)
C) Subclinical Rhythmic Electrographic Discharge of Adults (SREDA)
D) Focal temporal lobe seizure
Rationale: Rhythmic Mid-Temporal Theta of Drowsiness (RMTD),
formerly known as psychomotor variant, typically appears as a flat-
topped or notched 5-7 Hz rhythm in the mid-temporal regions during
light sleep and is a benign variant with no clinical significance.
2. While performing a neonatal EEG on a 34-week gestational
age infant, the technologist observes bursts of high-voltage
polymorphic activity (up to 200 µV) lasting 3–10 seconds,
separated by periods of lower voltage activity under 25 µV.
This pattern is best described as:
A) Trace Discontinu
B) Trace Alternant
C) Burst Suppression
D) Hypsarrhythmia
Rationale: Trace discontinu is the normal discontinuous pattern of
prematurity for infants under 35 weeks CA. Trace alternant is seen in
full-term infants during quiet sleep and has higher voltage inter-burst
activity.
,3. In a patient with suspected Creutzfeldt-Jakob Disease
(CJD), which of the following electrographic signatures would
most likely be captured on a routine EEG approximately 3 to 6
months after the onset of clinical symptoms?
A) Continuous generalized polymorphic delta activity
B) Periodic Sharp Wave Complexes (PSWCs) occurring at a
rate of 0.5 to 2 seconds
C) Triphasic waves with a prominent anterior-to-posterior lag
D) Generalized Paroxysmal Fast Activity (GPFA)
Rationale: CJD is classically associated with 1-2 Hz periodic sharp
wave complexes. While triphasic waves can look similar, they are more
associated with metabolic encephalopathy and usually show a time lag
across the scalp.
4. During the application of electrodes for a Long-Term
Monitoring (LTM) study, the technologist notes that the
impedance at Fp1 is 15 kOhms, while the rest of the electrodes
are at 2 kOhms. Why is this specific discrepancy a significant
concern for the integrity of the recording?
A) It will cause the patient to experience skin breakdown more quickly
B) It increases the likelihood of 60 Hz interference and
unbalanced common mode rejection
C) It will cause the amplifier to automatically shut down the channel
D) It results in a significant decrease in the amplitude of the brain waves
at that site
Rationale: High or unequal impedances degrade the Common Mode
Rejection Ratio (CMRR), making the channel much more susceptible to
ambient electrical noise (60 Hz).
5. A 22-year-old patient is referred for an EEG to evaluate
"episodes of staring and lip-smacking." The technologist
observes a 3 Hz spike-and-slow-wave discharge that is
triggered by hyperventilation and lasts for 12 seconds. The
patient is unable to recall a word given during the discharge.
This most likely represents:
A) A complex partial seizure
B) An Absence seizure
C) Atypical absence seizure
D) Lennox-Gastaut Syndrome
Rationale: Classic 3 Hz spike-and-wave is the hallmark of Absence
,epilepsy. Impairment of consciousness during the discharge is required
for the diagnosis of a clinical seizure.
6. When setting up an EEG on a patient with a massive right-
sided craniotomy, the technologist should expect to see which
of the following "breach rhythm" characteristics over the site
of the bone defect?
A) Attenuated voltage due to the lack of bone conduction
B) Increased amplitude and sharper morphology of beta and
alpha frequencies
C) Predominant polymorphic delta activity
D) Suppression of all normal background rhythms
Rationale: The skull acts as a low-pass filter. Without the bone, higher
frequency activity (beta) and normal rhythms appear much higher in
voltage and take on a "spiky" or "sharp" appearance.
7. A patient in the ICU is being monitored for status
epilepticus and is currently pharmacologically paralyzed. The
EEG shows a pattern of "waxing and waning" rhythmic delta
activity that evolves in frequency from 1 Hz to 3 Hz. What is
the most appropriate action for the technologist?
A) Continue recording as the patient is paralyzed and cannot have a
seizure
B) Notify the neurologist immediately as this likely represents
non-convulsive status epilepticus (NCSE)
C) Increase the sensitivity to see the waveforms more clearly
D) Change the montage to a circumferential montage to verify the origin
Rationale: Pharmacological paralysis masks the motor components of
a seizure. Electrographic evolution in frequency or location in a
comatose patient is highly suggestive of NCSE.
8. Which of the following digital filter settings would be most
appropriate to clearly visualize the "comb-like" appearance of
14 and 6 Hz Positive Spikes without distorting the waveform?
A) LFF 5.0 Hz, HFF 15 Hz
B) LFF 0.5 Hz, HFF 35 Hz
C) LFF 1.0 Hz, HFF 70 Hz
D) LFF 10 Hz, HFF 70 Hz
Rationale: Standard filter settings (LFF 0.5-1.0 Hz and HFF 70 Hz) are
necessary to preserve the morphology of fast transients like positive
spikes. Excessive filtering would dull the "sharp" component of the
spike.
, 9. In the context of the polarity convention used in EEG, if
Grid 1 (Input 1) is -50 µV and Grid 2 (Input 2) is -20 µV, what
will be the direction of the pen (or digital display) deflection?
A) Upward
B) Downward
C) No deflection
D) Equipotential
Rationale: EEG polarity convention states that if Input 1 is more
negative than Input 2, the deflection is upward. -50 is more negative
than -20.
10. A technologist is performing an EEG on a patient with
suspected Herpes Simplex Encephalitis (HSE). Which focal
EEG abnormality is most commonly associated with the early
stages of this condition?
A) Occipital spikes
B) Periodic Lateralized Epileptiform Discharges
(PLEDs/LPDs) over the temporal lobes
C) Generalized 3 Hz spike and wave
D) Central mu rhythm
Rationale: HSE has a predilection for the temporal lobes, often causing
focal swelling and Periodic Lateralized Epileptiform Discharges (now
termed LPDs) in those regions.
11. During a photic stimulation procedure, the EEG shows a
discharge that is time-locked to the flashes and disappears
immediately when the strobe stops. This is known as a:
A) Photoparoxysmal response
B) Photodriving response
C) Photomyogenic response
D) Photo-electric artifact
Rationale: Photodriving is a normal response where the brain's activity
synchronizes with the frequency of the light flashes.
12. The "Double Banana" montage is technically known as the:
A) Transverse Bipolar Montage
B) Longitudinal Bipolar Montage
C) Referential Montage
D) Laplacian Montage
Rationale: The longitudinal bipolar montage is called the double
banana due to the curved shape the electrode chains take on the scalp
map.
200 HIGH YIELD EXAM QUESTIONS
AND ANSWERS RATIONALE AND
EXPLANATIONS INCLUDED
ABRET EEG Board Review Practice Exam (2026 Edition)
1. A 45-year-old patient with a history of intractable focal
epilepsy is undergoing an EEG using the International 10-20
system. During the recording, a rhythmic 6 Hz discharge is
noted in the mid-temporal region that does not evolve in
frequency or morphology and is not associated with any
clinical symptoms. What is the most likely interpretation of
this finding?
A) Ictal rhythmic mid-temporal discharge (IRMTD)
B) Rhythmic Mid-Temporal Theta of Drowsiness
(Psychomotor Variant)
C) Subclinical Rhythmic Electrographic Discharge of Adults (SREDA)
D) Focal temporal lobe seizure
Rationale: Rhythmic Mid-Temporal Theta of Drowsiness (RMTD),
formerly known as psychomotor variant, typically appears as a flat-
topped or notched 5-7 Hz rhythm in the mid-temporal regions during
light sleep and is a benign variant with no clinical significance.
2. While performing a neonatal EEG on a 34-week gestational
age infant, the technologist observes bursts of high-voltage
polymorphic activity (up to 200 µV) lasting 3–10 seconds,
separated by periods of lower voltage activity under 25 µV.
This pattern is best described as:
A) Trace Discontinu
B) Trace Alternant
C) Burst Suppression
D) Hypsarrhythmia
Rationale: Trace discontinu is the normal discontinuous pattern of
prematurity for infants under 35 weeks CA. Trace alternant is seen in
full-term infants during quiet sleep and has higher voltage inter-burst
activity.
,3. In a patient with suspected Creutzfeldt-Jakob Disease
(CJD), which of the following electrographic signatures would
most likely be captured on a routine EEG approximately 3 to 6
months after the onset of clinical symptoms?
A) Continuous generalized polymorphic delta activity
B) Periodic Sharp Wave Complexes (PSWCs) occurring at a
rate of 0.5 to 2 seconds
C) Triphasic waves with a prominent anterior-to-posterior lag
D) Generalized Paroxysmal Fast Activity (GPFA)
Rationale: CJD is classically associated with 1-2 Hz periodic sharp
wave complexes. While triphasic waves can look similar, they are more
associated with metabolic encephalopathy and usually show a time lag
across the scalp.
4. During the application of electrodes for a Long-Term
Monitoring (LTM) study, the technologist notes that the
impedance at Fp1 is 15 kOhms, while the rest of the electrodes
are at 2 kOhms. Why is this specific discrepancy a significant
concern for the integrity of the recording?
A) It will cause the patient to experience skin breakdown more quickly
B) It increases the likelihood of 60 Hz interference and
unbalanced common mode rejection
C) It will cause the amplifier to automatically shut down the channel
D) It results in a significant decrease in the amplitude of the brain waves
at that site
Rationale: High or unequal impedances degrade the Common Mode
Rejection Ratio (CMRR), making the channel much more susceptible to
ambient electrical noise (60 Hz).
5. A 22-year-old patient is referred for an EEG to evaluate
"episodes of staring and lip-smacking." The technologist
observes a 3 Hz spike-and-slow-wave discharge that is
triggered by hyperventilation and lasts for 12 seconds. The
patient is unable to recall a word given during the discharge.
This most likely represents:
A) A complex partial seizure
B) An Absence seizure
C) Atypical absence seizure
D) Lennox-Gastaut Syndrome
Rationale: Classic 3 Hz spike-and-wave is the hallmark of Absence
,epilepsy. Impairment of consciousness during the discharge is required
for the diagnosis of a clinical seizure.
6. When setting up an EEG on a patient with a massive right-
sided craniotomy, the technologist should expect to see which
of the following "breach rhythm" characteristics over the site
of the bone defect?
A) Attenuated voltage due to the lack of bone conduction
B) Increased amplitude and sharper morphology of beta and
alpha frequencies
C) Predominant polymorphic delta activity
D) Suppression of all normal background rhythms
Rationale: The skull acts as a low-pass filter. Without the bone, higher
frequency activity (beta) and normal rhythms appear much higher in
voltage and take on a "spiky" or "sharp" appearance.
7. A patient in the ICU is being monitored for status
epilepticus and is currently pharmacologically paralyzed. The
EEG shows a pattern of "waxing and waning" rhythmic delta
activity that evolves in frequency from 1 Hz to 3 Hz. What is
the most appropriate action for the technologist?
A) Continue recording as the patient is paralyzed and cannot have a
seizure
B) Notify the neurologist immediately as this likely represents
non-convulsive status epilepticus (NCSE)
C) Increase the sensitivity to see the waveforms more clearly
D) Change the montage to a circumferential montage to verify the origin
Rationale: Pharmacological paralysis masks the motor components of
a seizure. Electrographic evolution in frequency or location in a
comatose patient is highly suggestive of NCSE.
8. Which of the following digital filter settings would be most
appropriate to clearly visualize the "comb-like" appearance of
14 and 6 Hz Positive Spikes without distorting the waveform?
A) LFF 5.0 Hz, HFF 15 Hz
B) LFF 0.5 Hz, HFF 35 Hz
C) LFF 1.0 Hz, HFF 70 Hz
D) LFF 10 Hz, HFF 70 Hz
Rationale: Standard filter settings (LFF 0.5-1.0 Hz and HFF 70 Hz) are
necessary to preserve the morphology of fast transients like positive
spikes. Excessive filtering would dull the "sharp" component of the
spike.
, 9. In the context of the polarity convention used in EEG, if
Grid 1 (Input 1) is -50 µV and Grid 2 (Input 2) is -20 µV, what
will be the direction of the pen (or digital display) deflection?
A) Upward
B) Downward
C) No deflection
D) Equipotential
Rationale: EEG polarity convention states that if Input 1 is more
negative than Input 2, the deflection is upward. -50 is more negative
than -20.
10. A technologist is performing an EEG on a patient with
suspected Herpes Simplex Encephalitis (HSE). Which focal
EEG abnormality is most commonly associated with the early
stages of this condition?
A) Occipital spikes
B) Periodic Lateralized Epileptiform Discharges
(PLEDs/LPDs) over the temporal lobes
C) Generalized 3 Hz spike and wave
D) Central mu rhythm
Rationale: HSE has a predilection for the temporal lobes, often causing
focal swelling and Periodic Lateralized Epileptiform Discharges (now
termed LPDs) in those regions.
11. During a photic stimulation procedure, the EEG shows a
discharge that is time-locked to the flashes and disappears
immediately when the strobe stops. This is known as a:
A) Photoparoxysmal response
B) Photodriving response
C) Photomyogenic response
D) Photo-electric artifact
Rationale: Photodriving is a normal response where the brain's activity
synchronizes with the frequency of the light flashes.
12. The "Double Banana" montage is technically known as the:
A) Transverse Bipolar Montage
B) Longitudinal Bipolar Montage
C) Referential Montage
D) Laplacian Montage
Rationale: The longitudinal bipolar montage is called the double
banana due to the curved shape the electrode chains take on the scalp
map.
