CLTM BOARD TEST EXAM 2025/2026 BANK ACCURATE CURRENTLY TESTING
EXAM 2 VERSIONS WITH ACTUAL QUESTIONS AND DETAILED ANSWERS
Question 1
Which type of surgical resection is most commonly associated with the treatment of medial
temporal sclerosis?
A) Frontal lobectomy
B) Selective amygdalohippocampectomy
C) Temporal lobectomy
D) Corpus callosotomy
E) Multiple subpial transection
Correct Answer: C) Temporal lobectomy
Rationale: Medial temporal sclerosis (MTS) is the most common cause of drug-resistant
temporal lobe epilepsy. A temporal lobectomy, which involves the removal of the anterior
temporal lobe along with the amygdala and hippocampus, is the standard surgical
procedure to achieve seizure freedom when MTS is identified as the source of ictal onset.
Question 2
Temporal lobe epilepsy is the most prevalent form of focal epilepsy in adults. It accounts for
approximately what percentage of all adult patients with epilepsy?
A) 20%
B) 40%
C) 60%
D) 80%
E) 95%
Correct Answer: C) 60%
Rationale: Temporal lobe epilepsy (TLE) is the most common form of localization-related
epilepsy in the adult population, representing roughly 60% of cases. Understanding this
prevalence is critical for CLTM providers, as a majority of long-term monitoring cases in
the EMU will involve temporal lobe evaluations.
Question 3
When managing a pregnant woman with epilepsy, which of the following Anti-Epileptic Drugs
, 2
(AEDs) is generally considered to have the lowest risk of teratogenic effects?
A) Valproic Acid
B) Phenytoin
C) Lamotrigine (Lamictal)
D) Carbamazepine
E) Phenobarbital
Correct Answer: C) Lamotrigine (Lamictal)
Rationale: Lamictal (lamotrigine) and Levetiracetam (Keppra) are considered the safest
options during pregnancy compared to Valproate, which carries a high risk of neural tube
defects and cognitive impairment. LAM is associated with lower rates of major congenital
malformations, although clinicians must monitor blood levels closely due to increased
clearance during pregnancy.
Question 4
The EEG pattern known as hypsarrhythmia, characterized by high-voltage, disorganized
background activity with multifocal spikes, is most often associated with which clinical
condition?
A) Lennox-Gastaut Syndrome
B) Benign Rolandic Epilepsy
C) Infantile Spasms (West Syndrome)
D) Juvenile Myoclonic Epilepsy
E) Absence Epilepsy
Correct Answer: C) Infantile Spasms (West Syndrome)
Rationale: Hypsarrhythmia is the hallmark EEG finding of West Syndrome, which presents
clinically as infantile spasms. This pattern indicates a highly chaotic brain state. Early
recognition on EEG is vital because the associated spasms require specific treatments like
ACTH or Vigabatrin to prevent severe developmental regression.
Question 5
Which region of the brain is primarily responsible for expressive speech and language
production?
, 3
A) Wernicke's area
B) Heschl's gyrus
C) Primary motor cortex
D) Broca's area
E) Angular gyrus
Correct Answer: D) Broca's area
Rationale: Broca’s area is located in the posterior part of the inferior frontal gyrus of the
dominant hemisphere (usually the left). It manages the motor aspects of speech production.
Damage to this area results in expressive aphasia, where the patient understands language
but cannot produce fluent speech.
Question 6
Vagus Nerve Stimulators (VNS) are FDA-approved as an adjunctive treatment for patients
experiencing which type of seizures?
A) Generalized Absence seizures
B) Myoclonic seizures
C) Partial (Focal) seizures
D) Gelastic seizures
E) Tonic-clonic seizures only
Correct Answer: C) partial seizures
Rationale: VNS therapy involves a device implanted in the chest that sends regular
electrical pulses to the brain via the vagus nerve. It is specifically approved for patients
over 4 years of age with focal (partial) onset seizures that are refractory to medication and
who are not candidates for resective surgery.
Question 7
The administration of Phenobarbital is expected to produce which of the following changes on a
patient's EEG background?
A) Generalized slowing (Delta)
B) Increased Beta activity
C) Temporal Theta bursts
, 4
D) Suppression of all activity
E) Alpha squeak
Correct Answer: B) Beta
Rationale: Barbiturates like Phenobarbital and benzodiazepines are known to induce fast-
frequency Beta activity (usually 13-30 Hz) on the EEG, particularly in the frontal regions.
This is a normal pharmacological effect and should be documented by the technologist to
avoid confusing it with an irritable or pathological state.
Question 8
Data from Continuous EEG (CEEG) monitoring shows that the majority of seizures detected in
the Intensive Care Unit (ICU) are:
A) Generalized tonic-clonic
B) Focal motor seizures
C) Non-convulsive
D) Myoclonic jerks
E) Psychogenic
Correct Answer: C) non convulsive
Rationale: Seizures in critically ill patients are often "subclinical" or non-convulsive. They
lack obvious motor movements and can only be identified via CEEG. Without monitoring,
these seizures—which can lead to permanent brain injury—would go untreated in a
significant percentage of ICU patients.
Question 9
In the acute management of Status Epilepticus, which medication is typically utilized as the first-
line "emergency" treatment to stop the seizure?
A) Ethosuximide
B) Valproic Acid
C) Lorazepam
D) Gabapentin
E) Lamotrigine
EXAM 2 VERSIONS WITH ACTUAL QUESTIONS AND DETAILED ANSWERS
Question 1
Which type of surgical resection is most commonly associated with the treatment of medial
temporal sclerosis?
A) Frontal lobectomy
B) Selective amygdalohippocampectomy
C) Temporal lobectomy
D) Corpus callosotomy
E) Multiple subpial transection
Correct Answer: C) Temporal lobectomy
Rationale: Medial temporal sclerosis (MTS) is the most common cause of drug-resistant
temporal lobe epilepsy. A temporal lobectomy, which involves the removal of the anterior
temporal lobe along with the amygdala and hippocampus, is the standard surgical
procedure to achieve seizure freedom when MTS is identified as the source of ictal onset.
Question 2
Temporal lobe epilepsy is the most prevalent form of focal epilepsy in adults. It accounts for
approximately what percentage of all adult patients with epilepsy?
A) 20%
B) 40%
C) 60%
D) 80%
E) 95%
Correct Answer: C) 60%
Rationale: Temporal lobe epilepsy (TLE) is the most common form of localization-related
epilepsy in the adult population, representing roughly 60% of cases. Understanding this
prevalence is critical for CLTM providers, as a majority of long-term monitoring cases in
the EMU will involve temporal lobe evaluations.
Question 3
When managing a pregnant woman with epilepsy, which of the following Anti-Epileptic Drugs
, 2
(AEDs) is generally considered to have the lowest risk of teratogenic effects?
A) Valproic Acid
B) Phenytoin
C) Lamotrigine (Lamictal)
D) Carbamazepine
E) Phenobarbital
Correct Answer: C) Lamotrigine (Lamictal)
Rationale: Lamictal (lamotrigine) and Levetiracetam (Keppra) are considered the safest
options during pregnancy compared to Valproate, which carries a high risk of neural tube
defects and cognitive impairment. LAM is associated with lower rates of major congenital
malformations, although clinicians must monitor blood levels closely due to increased
clearance during pregnancy.
Question 4
The EEG pattern known as hypsarrhythmia, characterized by high-voltage, disorganized
background activity with multifocal spikes, is most often associated with which clinical
condition?
A) Lennox-Gastaut Syndrome
B) Benign Rolandic Epilepsy
C) Infantile Spasms (West Syndrome)
D) Juvenile Myoclonic Epilepsy
E) Absence Epilepsy
Correct Answer: C) Infantile Spasms (West Syndrome)
Rationale: Hypsarrhythmia is the hallmark EEG finding of West Syndrome, which presents
clinically as infantile spasms. This pattern indicates a highly chaotic brain state. Early
recognition on EEG is vital because the associated spasms require specific treatments like
ACTH or Vigabatrin to prevent severe developmental regression.
Question 5
Which region of the brain is primarily responsible for expressive speech and language
production?
, 3
A) Wernicke's area
B) Heschl's gyrus
C) Primary motor cortex
D) Broca's area
E) Angular gyrus
Correct Answer: D) Broca's area
Rationale: Broca’s area is located in the posterior part of the inferior frontal gyrus of the
dominant hemisphere (usually the left). It manages the motor aspects of speech production.
Damage to this area results in expressive aphasia, where the patient understands language
but cannot produce fluent speech.
Question 6
Vagus Nerve Stimulators (VNS) are FDA-approved as an adjunctive treatment for patients
experiencing which type of seizures?
A) Generalized Absence seizures
B) Myoclonic seizures
C) Partial (Focal) seizures
D) Gelastic seizures
E) Tonic-clonic seizures only
Correct Answer: C) partial seizures
Rationale: VNS therapy involves a device implanted in the chest that sends regular
electrical pulses to the brain via the vagus nerve. It is specifically approved for patients
over 4 years of age with focal (partial) onset seizures that are refractory to medication and
who are not candidates for resective surgery.
Question 7
The administration of Phenobarbital is expected to produce which of the following changes on a
patient's EEG background?
A) Generalized slowing (Delta)
B) Increased Beta activity
C) Temporal Theta bursts
, 4
D) Suppression of all activity
E) Alpha squeak
Correct Answer: B) Beta
Rationale: Barbiturates like Phenobarbital and benzodiazepines are known to induce fast-
frequency Beta activity (usually 13-30 Hz) on the EEG, particularly in the frontal regions.
This is a normal pharmacological effect and should be documented by the technologist to
avoid confusing it with an irritable or pathological state.
Question 8
Data from Continuous EEG (CEEG) monitoring shows that the majority of seizures detected in
the Intensive Care Unit (ICU) are:
A) Generalized tonic-clonic
B) Focal motor seizures
C) Non-convulsive
D) Myoclonic jerks
E) Psychogenic
Correct Answer: C) non convulsive
Rationale: Seizures in critically ill patients are often "subclinical" or non-convulsive. They
lack obvious motor movements and can only be identified via CEEG. Without monitoring,
these seizures—which can lead to permanent brain injury—would go untreated in a
significant percentage of ICU patients.
Question 9
In the acute management of Status Epilepticus, which medication is typically utilized as the first-
line "emergency" treatment to stop the seizure?
A) Ethosuximide
B) Valproic Acid
C) Lorazepam
D) Gabapentin
E) Lamotrigine
