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EEG BOARD EXAM ACTUAL QUESTIONS AND CORRECT ANSWERS WITH RATIONALES.. It contains 240
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accompanied by a correct answer and a detailed rationale that explains the underlying pathophysiology,
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Review Summary 240 Questions
Foundations - Application - EEG Board Actual AND Correct WITH Rationales Clinical Neurophysiology
EEG Board Examination Graduate / Advanced Practicum
All answers with rationales
,Table of Contents
Section A - EEG Instrumentation AND Section B - Normal EEG Patterns AND
Recording Techniques Variants
Questions 1 to 60 Questions 61 to 120
Section C - EEG IN Epilepsy AND Section D - EEG IN COMA AND Brain
Seizure Disorders Death
Questions 121 to 180 Questions 181 to 240
,Section A - EEG Instrumentation AND Recording
Techniques
Q1.
A 60-second EEG epoch shows a generalized burst of rhythmic 6 Hz spike-and-wave
complexes that begin and end abruptly, without any preceding slowing or clinical
correlate. Which of the following is the most appropriate interpretation?
A. Typical absence seizure B. Generalized paroxysmal fast activity
C. 6 Hz spike-and-wave (phantom D. Benign epileptiform transients of sleep
spike-wave) pattern
Correct: C - 6 Hz spike-and-wave (phantom spike-wave) pattern
Rationale:6 Hz spike-and-wave (phantom spike-wave) bursts are typically brief, generalized,
and occur without clinical accompaniment. They are often considered a normal variant,
especially when the spike component is low amplitude. Typical absence seizures are
associated with 3 Hz spike-and-wave and clinical impairment. Generalized paroxysmal fast
activity is a different pattern. Benign epileptiform transients are focal and occur during
drowsiness.
Q2.
During an EEG recording, a patient has a generalized tonic-clonic seizure. Immediately
after the seizure ends, the EEG shows diffuse voltage attenuation followed by slow waves.
Which of the following best describes the expected postictal EEG pattern?
A. Electroclinical dissociation B. Postictal generalized EEG suppression
(PGES)
C. Burst suppression pattern D. Electrodecremental response
Correct: B - Postictal generalized EEG suppression (PGES)
Rationale:Postictal generalized EEG suppression (PGES) is characterized by diffuse voltage
attenuation following a generalized tonic-clonic seizure. It is associated with sudden
unexpected death in epilepsy (SUDEP). Electrodecremental response is seen at seizure
onset. Burst suppression is seen in coma or anesthesia. Electroclinical dissociation refers to
dissociation between EEG and clinical signs.
Q3.
A routine EEG reveals runs of sinusoidal 14-16 Hz activity over the vertex and central
regions during drowsiness. This activity is most consistent with which of the following?
A. Alpha rhythm B. Beta activity
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, Section A - EEG Instrumentation AND Recording Techniques
C. Mu rhythm D. Sleep spindles
Correct: D - Sleep spindles
Rationale:Sleep spindles are 11-16 Hz (typically 12-14 Hz) sinusoidal bursts that appear
during stage N2 sleep, maximal over the vertex. Alpha rhythm is 8-13 Hz posterior dominant.
Beta activity is >13 Hz, often frontocentral. Mu rhythm is 7-11 Hz, arch-shaped, over the
central region, and attenuates with contralateral movement.
Q4.
Which of the following EEG patterns is most commonly associated with a poor prognosis
in comatose patients after cardiac arrest, particularly when present in the first 24 hours?
A. Generalized periodic discharges (GPDs) B. Burst suppression with identical bursts
C. Alpha coma pattern D. Reactivity to external stimuli
Correct: B - Burst suppression with identical bursts
Rationale:Burst suppression with identical bursts (i.e., stereotyped morphology across
bursts) is a highly malignant pattern after cardiac arrest and predicts poor outcome.
Generalized periodic discharges have variable prognostic significance. Alpha coma (alpha
frequency activity unresponsive to stimuli) carries a poor prognosis but is less specific.
Reactivity is a favorable prognostic sign.
Q5.
A 35-year-old patient with a history of epilepsy has an EEG that shows frequent left
temporal spike-and-wave discharges. Which of the following is the most appropriate next
step to increase the yield of capturing interictal epileptiform discharges?
A. Perform hyperventilation for 5 minutes B. Administer intravenous diazepam
C. Increase the low-frequency filter to 1 Hz D. Decrease the high-frequency filter to 35
Hz
Correct: A - Perform hyperventilation for 5 minutes
Rationale:Hyperventilation is a standard activation procedure that can provoke interictal
epileptiform discharges, particularly in generalized and temporal lobe epilepsies. Diazepam
suppresses epileptiform activity. Filter adjustments (low-frequency filter increase,
high-frequency filter decrease) reduce artifact but may also attenuate epileptiform discharges,
decreasing yield.
Q6.
Which of the following is the most reliable EEG feature to distinguish psychogenic
nonepileptic seizures (PNES) from epileptic seizures during a prolonged video-EEG
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