EEG 210- Final Exam Review Questions and Answers 100% Pass

EEG 210- Final Exam Review Questions and Answers 100% Pass True or False: It is the responsibility of the technologist, during the recording, to prove or verify whether a waveform is artifact or not. - True A potentially misread artifact that mimics high amplitude frontal spikes is: - EMG from the muscles of the forehead An orderly approach to EEG includes asking which of the following questions? - -Is extracerebral activity physiologic or non-physiologic -Is Extracerebral Activity continuous or intermittent, focal or diffuse, intrensic or extrinsic, environental or instrumental, and is the source resolvable or unresolvable? -Is cerebral activity continuous or intermittent, epielptiform or nonepileptiform and then either normal or abnormal? -Is the activity cerebral or extracerebral? -Is cerebral cctivity focal or generalized? Wickets, SSS or BETS, RMTD or Rhythmic Mid-Temporal Theta Discharges of Drowsiness), 14 & 6 Hz Positive Spikes, SREDA - Normal variants that may cause confusion in EEG recordings Classification Quantification Localization - Ways in which EEG can help clarify diagnosis and treatment 30% - Percentage of patients referred to epilepsy centers for refractory seizures who are misdiagnosed 2 | P a g e Author. Emily Charlene, ©2025 All Rights Reserved. Quiet patient, controlled setting, and qualified EEG Technologist - Optimal recording environment First recording 29-55% Second recording with use of sleep deprivation increases to 85% - How much does a second EEG increase the likelihood of recording an epileptic abnormality? True or False: When using scalp electrodes, a normal clinical EEG excludes subclinical focal seizures. - False When using scalp electrodes, a normal clinical EEG excludes subclinical focal seizures. - Video the patient during the recording if possible, and monitor any potential artifacts such as EMG, Tremor, Head Movement, Respiration, Eye movements, Tongue movements, or any artifact originating from the patient or the environment. Doll's eyes: eyes move as head moves - Stimulus in: Optic Nerve (vision), Vestibulo-cochlear (hearing and equilibrium), Spinal Accessory (trapezius, neck, swallow) - Response out: oculomotor nerve (eyelid and eyeball movements), Abducens (lateral eyeball movement) Cerebral Angiography Cerebral Scintigraphy (Radionucleide Scan) Transcranial Doppler Ultrasound CT Angiography (CTA) (controversial Somatosensory Evoked Potentials (controversial) - Ancillary tests Pupil response: Stimulus in - Optic nerve (Vision) - Response out: oculomotor nerve (eyelid and eyeball movements) Pain responses exam - Evidence of brainstem function Gag test Stimulus in: Vagus nerve (senses and control of digestive organs, taste, slows heart rate) - glossopharyngeal nerve (taste, senses carotic BP), hypoglossal nerve (controls tongue movement) Apnea Test: Absence of breathing drive Prerequisites: 1. Normotension 2. Normothermia 3. Euvolemia 4. Eucapnia (PaCo2 35-45 mm Hg) 5. Absence of hypoxia 6. No prior evidence of Co2 retention (i.e. chronic 3 | P a g e Author. Emily Charlene, ©2025 All Rights Reserved. obstructive pulmonary disease or severe obesity) - Abort the test if the patient becomes unstable (Hypoxic, Hypotensive, or develops cardiac arrhythmias) In an ICS/ECI recording, the interelectrode distances should be: - at least greater than or equal to 10 cm True or False: When performing an ECS/ECI recording, there should be NO EEG reactivity to INTENSE somatosensory, auditory and visual stimuli. - True Tapping each electrode in an ECI/ECS recording is done to: - test the integrity of the entire system How many electrodes are needed to perform an ECS/ECI (evaluation for brain death) EEG Study, to ensure that focal attenuation is not mistaken for electrocerebral inactivity? - the full set of International 10-20 System electrodes True or False: When performing an ECS/ECI recording, additional monitoring techniques should be employed when necessary, and every effort made to eliminate and/or identify and document any sources of artifact such as IV drips, electric beds, EKG, respiration and movement. Common artifacts can be monitored with EKG, EMG and respiratory monitoring channels. - True Impedances in an ECI/ECS recording should range: - less than 10K Ohms but more than 100 Ohms In an ECS/ECI recording the sensitivity should be: - 2μV/mm for at least 30 minutes of the recording True or False: According to ACNS Guidelines 6: Low frequency filter in ECS/ECI recordings should not be set above 1 Hz to avoid eliminating slow potentials and the high frequency filter should not be set below 30 Hz to avoid elimination of high frequency potentials. The 60-Hz notch filter can be used with care, and only after appropriate troubleshooting is performed. If the 60-Hz filter is used, segments of EEG should also be recorded without this filter for comparison. - True 4 | P a g e Author. Emily Charlene, ©2025 All Rights Reserved. States that an individual is dead after irreversible cessation of circulatory functions or all functions of the entire brain, including the brainstem - Uniform Determination of Death Act (UDDA) approved for the US in 1980 Tests that can also be done to confirm the diagnosis when unable to do a complete physical examination such as in the presence of a facial injury but these tests to not supplant the physical exam or the apnea test, but only add to it - Ancillary testing Irreversible cessation of circulatory and respiratory function - Cardiorespiratory Death No EEG Activity over 2 μV when recording from scalp electrode pairs greater than or equal to 10 cm apart, with impedances under 10K Ohms, but over 100 Ohms. - ECI (Electrocerebral Inactivity) or ECS (Electrocerebral Silence) Can be caused by general anesthesia, severe intoxication, or hypothermia - Isoelectric or flatline EEG EEG is determined by: - -Brainstem Modulation of the Reticular Activating System -Intracortical Connections -Thalmocortical Connections In a Left Parietal AVM with Hemorrhage, where there is involvement of white matter as well as grey matter, what changes are expected on the EEG? - Slowing with suppression of alpha In a left posterior Middle Cerebral Artery stroke, that shows clearly on Flair MRI, why did the EEG show no slowing? - Slowing appears in response to white matter lesions and the the MRI in this case shows predominately grey matter injury thus slowing may not be expected. Loss of Cortical Neurons without changes in connectivity may only cause reduction in EEG amplitudes