CLTM LATEST EXAM TEST PAPER QUESTIONS AND
ANSWERS SURE A+
✔✔What is the age of onset and seizure type in childhood epilepsy with centrotemporal
spikes?
- Formerly benign childhood epilepsy with centrotemporal spikes or Rolandic Epilepsy -
✔✔Onset: 3-14 yrs of age (peak 8-9 year of age)
Seizure type: Seizures with frontoparietal opercular features such as hemifacial clonic
movements, laryngeal symptoms, articulation difficulty, swallowing or chewing
movements, and hypersalivation.
✔✔Describe the seizure type and interictal EEG finding in childhood occipital epilepsy
(Gastaut type) - ✔✔Seizure Type: Brief focal sensory visual seizures that occur during
wakefulness. Visual phenomena might be described as small colored circles and might
be followed by ipsilateral head or eye deviation.
Interictal EEG: Occipital spikes or spike-wave discharges. These might only be present
in sleep. In 20% of patients, frontal, centrotemporal, or generalized spike-wave
discharges might co-exist.
✔✔Describe the age of onset and seizure types in Dravet syndrome. - ✔✔Onset:
Usually in the first year of life, typically around 6 months of age; although, some cases
occur into the 2nd year of life.
Seizure Types: Focal or generalized seizure types. The first seizure is febrile in 60% or
patients. Hemiclonic seizures are commone and may involve different sides of the body
in different seizures. Patients may also develop atypical absence, myoclonic, and atnoci
seizures.
✔✔Describe the seizure type and interictal EEG finding in Panayiotopoulos syndrome -
✔✔Seizure type: focal autonomic seiuzre that are often prolonged usually involving
nausea, retching, or vomiting or other autonoimc changes.
Interictal EEG finding: multifocal high voltage repetitive spikes or sharp waves; 60% of
patients have occipital spikes
✔✔Describe the age of onset, seizure types, and interictal EEG finding in juvenile
myoclonic epilepsy (JME) - ✔✔Onset: 8 to 25 years of age
Seizure Types: All patients have myoclonic seizures. These commonly occur after
waking. Most patients also have GTS (over 90%), and some patients also have typical
absence seizures (one-third).
Interictal EEG: 3.5-to 6 HZ generalized spike-wave or polyspike-wave discharges.
✔✔Describe the age of onset, initial clinical presentation, and seizure types of Landau-
Kleffner syndrome. - ✔✔Onset: 2 to 8 years of age (peak 5 to 7)
Clinical Presentation: Patients initially present with progressive aphasia, seizures, or
both.
, Seizure Types: Seizures are usually infrequent and nocturnal; however, 20-30% of
patients don't have seizures. When seizures are present, patients might have focal
seizures, atypical absence seizures, or atonic seizures.
✔✔DEscribe the age of onset, seizures types, and EEG findings in Lennox-Gastaut
syndrome (LGS). - ✔✔Onset: 1 to 7 years (peak 3 to 5 years)
Seizure Types: Multiple types of intractable seizures. Tonic seizures in sleep or upon
awakening are most characteristic.
EEG: slow spike-and wive- (2.5Hz) and paroxysmal fast activity in sleep.
✔✔Describe the age of onset, seizure type, and EEG findings in West Syndrome. -
✔✔Onset: 3 to 12 months of age
Seizure type: Epileptic spasms (also known as infantile spasms)
EEG findings: Hypsarrhythmia or modified hypsarrhythmia. The ictal EEG displays a
high voltage slow wave followed by low amplitude fast activity and voltage attenuation.
✔✔Acquired verbal auditory agnosia, language regression, EEG abnormalities, and
seizres* are associated with what disorder? - ✔✔Landau-Kleffner Syndrome (LKS)
*Note-20-30% of patients do not experience seizures.
✔✔What types of procedures can be performed to provoke epileptiform abnormalities? -
✔✔-Suggestion
-Hyperventilation
-Exercise
-Photic stimulation
-Sleep/Sleep deprivation
-Re-enactment of precipitating events
✔✔What are the benefits of sleep recording during LTM? - ✔✔Sleep disorders can
often be confused with epileptic seizures.
Many patients with epilepsy display interictal epileptiform discharges (IEDs) and/or
seizures during sleep.
Sleep recordings contain limited artifact.
Sleep is an unlikely time for a psychogenic non-epileptic event.
✔✔Which patient care item category do scalp electrodes fall under: non-critical, semi-
critical, or critical, and why? - ✔✔Semi-critical (items in contact with non-inact skin)
because skin preparartion with any abrasive to lower impedance creates non-intact skin
on the patient.
✔✔What is the best practice to properly identify a patient? - ✔✔Use two identifiers (e.g.,
name, DOB, MRN, ect.)
ANSWERS SURE A+
✔✔What is the age of onset and seizure type in childhood epilepsy with centrotemporal
spikes?
- Formerly benign childhood epilepsy with centrotemporal spikes or Rolandic Epilepsy -
✔✔Onset: 3-14 yrs of age (peak 8-9 year of age)
Seizure type: Seizures with frontoparietal opercular features such as hemifacial clonic
movements, laryngeal symptoms, articulation difficulty, swallowing or chewing
movements, and hypersalivation.
✔✔Describe the seizure type and interictal EEG finding in childhood occipital epilepsy
(Gastaut type) - ✔✔Seizure Type: Brief focal sensory visual seizures that occur during
wakefulness. Visual phenomena might be described as small colored circles and might
be followed by ipsilateral head or eye deviation.
Interictal EEG: Occipital spikes or spike-wave discharges. These might only be present
in sleep. In 20% of patients, frontal, centrotemporal, or generalized spike-wave
discharges might co-exist.
✔✔Describe the age of onset and seizure types in Dravet syndrome. - ✔✔Onset:
Usually in the first year of life, typically around 6 months of age; although, some cases
occur into the 2nd year of life.
Seizure Types: Focal or generalized seizure types. The first seizure is febrile in 60% or
patients. Hemiclonic seizures are commone and may involve different sides of the body
in different seizures. Patients may also develop atypical absence, myoclonic, and atnoci
seizures.
✔✔Describe the seizure type and interictal EEG finding in Panayiotopoulos syndrome -
✔✔Seizure type: focal autonomic seiuzre that are often prolonged usually involving
nausea, retching, or vomiting or other autonoimc changes.
Interictal EEG finding: multifocal high voltage repetitive spikes or sharp waves; 60% of
patients have occipital spikes
✔✔Describe the age of onset, seizure types, and interictal EEG finding in juvenile
myoclonic epilepsy (JME) - ✔✔Onset: 8 to 25 years of age
Seizure Types: All patients have myoclonic seizures. These commonly occur after
waking. Most patients also have GTS (over 90%), and some patients also have typical
absence seizures (one-third).
Interictal EEG: 3.5-to 6 HZ generalized spike-wave or polyspike-wave discharges.
✔✔Describe the age of onset, initial clinical presentation, and seizure types of Landau-
Kleffner syndrome. - ✔✔Onset: 2 to 8 years of age (peak 5 to 7)
Clinical Presentation: Patients initially present with progressive aphasia, seizures, or
both.
, Seizure Types: Seizures are usually infrequent and nocturnal; however, 20-30% of
patients don't have seizures. When seizures are present, patients might have focal
seizures, atypical absence seizures, or atonic seizures.
✔✔DEscribe the age of onset, seizures types, and EEG findings in Lennox-Gastaut
syndrome (LGS). - ✔✔Onset: 1 to 7 years (peak 3 to 5 years)
Seizure Types: Multiple types of intractable seizures. Tonic seizures in sleep or upon
awakening are most characteristic.
EEG: slow spike-and wive- (2.5Hz) and paroxysmal fast activity in sleep.
✔✔Describe the age of onset, seizure type, and EEG findings in West Syndrome. -
✔✔Onset: 3 to 12 months of age
Seizure type: Epileptic spasms (also known as infantile spasms)
EEG findings: Hypsarrhythmia or modified hypsarrhythmia. The ictal EEG displays a
high voltage slow wave followed by low amplitude fast activity and voltage attenuation.
✔✔Acquired verbal auditory agnosia, language regression, EEG abnormalities, and
seizres* are associated with what disorder? - ✔✔Landau-Kleffner Syndrome (LKS)
*Note-20-30% of patients do not experience seizures.
✔✔What types of procedures can be performed to provoke epileptiform abnormalities? -
✔✔-Suggestion
-Hyperventilation
-Exercise
-Photic stimulation
-Sleep/Sleep deprivation
-Re-enactment of precipitating events
✔✔What are the benefits of sleep recording during LTM? - ✔✔Sleep disorders can
often be confused with epileptic seizures.
Many patients with epilepsy display interictal epileptiform discharges (IEDs) and/or
seizures during sleep.
Sleep recordings contain limited artifact.
Sleep is an unlikely time for a psychogenic non-epileptic event.
✔✔Which patient care item category do scalp electrodes fall under: non-critical, semi-
critical, or critical, and why? - ✔✔Semi-critical (items in contact with non-inact skin)
because skin preparartion with any abrasive to lower impedance creates non-intact skin
on the patient.
✔✔What is the best practice to properly identify a patient? - ✔✔Use two identifiers (e.g.,
name, DOB, MRN, ect.)
