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CLTM Stack 1 Study Guide: 139 Practice Questions with Detailed Answers for Certification in Long-Term Monitoring ( Edition)

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This comprehensive study guide is your essential resource for passing the CLTM (Certification in Long-Term Monitoring) board exam and advancing your career as a Neurodiagnostic Technologist. Featuring 139 exam-style questions with verified answers and detailed rationales, this guide covers every critical topic tested on the exam, including EEG patterns, seizure semiology, epilepsy syndromes, surgical evaluation, intracranial monitoring, and functional mapping. You will master the specifics of epilepsy syndromes across the lifespan (neonatal, childhood, and adult),

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CLTM STACK 1 2026/2027 WITH 139
QUESTIONS AND CORRECT ANSWERS
RATED A+
Describe a slow wave
Frequency of 3-5 Hz.
Delta, theta.
Decreases in prominence with age.
AED
Antiepileptic drug
BAER
brainstem auditory evoked response
Also called BAEP-brainstem auditory evoked potentials.
Useful in diagnosis of cerebellopontine angle tumors, multiple sclerosis, brainstem
lesions, metabolic and toxic encephalopathies, and early prediction of outcome in
posttraumatic coma.
Also used in assessing brain death.
Kindling
Development of epileptic seizures (in rats) that results from repeated focal
stimulation and leads to the development of a predisposition to epileptiform
convulsions.
Just as a large log will not burn unless kindled, the theory suggests epilepsy
requires a similar kind of kindling by a sequential series of small electrical stimuli.
-Goddard GC. The kindling model of epilepsy. Trends in Neurosciences, 1983 Vol.
6:275-9.
Describe a sharp wave
Transient, clearly distinguishable from background activity with pointed peak and
a duration of 70-200ms.
Describe a spike

,Duration less that 70ms.
Transient, clearly distinguishable from background activity with a pointed peak.
SUDEP
Sudden unexpected death in epilepsy.
SUDEP is the most important, direct epilepsy-related cause of death, and excludes
death resulting from status epilepticus.


Mirror Focus Phenomenon
Concept that an actively discharging epileptiform region may induce similar
paroxysmal behavior in a homologous site.
Related to the kindling phenomena that occur through interhemispheric callosal or
commissural connections. It means that secondary epileptogenic foci develop in
the contralateral hemisphere by the corpus callosum.
-McCarthy RJ et al. Journal of Epilepsy 1997 Mar;10(2):78-85.
Aura
Initial sensation(s) of a seizure that the patient is aware of in the absence of
observable signs. Provides localizing information in some cases. Precedes temporal
lob seizures in many cases.
What type of seizure is the AED, Oxcarbazepine (Trileptal, Oxtellar XR), used to
treat?
All types of focal (partial) seizures.
The first line AED treatment option for juvenile myoclonic epilepsy is:
Valproic acid
What AED is used to treat seizures that occur in the temporal lobe?
Carbamazepine (Carbatrol, Tegretol/Epiol/Equetro)
Indications for corpus callosotomy
Refractory generalized seizures (tonic, clonic, and atonic), resistance to
antiepileptic drug therapy, and cognitive decline. Infantile hemiplegia and frontal

, lobe epilepsy, Rasmussen syndrome. Primary indications have been drop attacks
(both tonic and atonic) and in treatment of Lennox-Gastaut syndrome.
What are some EEG changes associated with normal aging?
Slowing of dominant rhythm, increase in temporal slowing, bursts of generalized
rhythmic delta activity during drowsiness, diffuse lower amplitude
Trace discontinue which appears in a 42 week conceptual age neonate is
considered?
a. Abnoramal
b. Normal
c. Trace discontinu in not a neonatal EEG patten
Abnormal

Trace discontinu is the defining feature of quiet sleep first emerging around 28
weeks MPA.
By 34-36 weeks trace discontinu is seen only in quiet sleep. The amount of time
with a trace discontinue pattern decreases with increasing PMA so that a term
infant has rare, if any, periods of trace discontinu in quiet sleep.
By 37-40 weeks, trace alternant fully replaces trace discontinu.


What is the principle of beneficence?
An ethical principle that addresses the idea that a medical professionals actions
should promote good by having the welfare of the patient as a goal of any
treatment. Actions should weigh possible benefits of risks and prevent and remove
harm in any situation and should advocate for high standards for the greater good.
QEEG
Quantitative EEG allows for visualization of up to several hours of EEG data in a
single screen display. Commonly referred to as "trend analysis". QEEG trending
for seizure detection is based on: amplitude, frequency, rhythmicity, and degree of
asymmetry.
Coup and Contrecoup

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