Multiple Choice Question Based on Newer Anti-Epileptic Drugs

• Q.1 Which of the following conditions should be met for speech arrest during cortical stimulation to reliably indicate that the electrode overlies language-eloquent cortex?

  • A) Effects on tongue mobility

  • B) No significant EEG after discharge

  • C) Eloquent reference electrode

  • D) Patient has a seizure

• Q.2 Which of the following is the most highly significant and characteristic electrocortigraphic finding of focal cortical dysplasia?

  • A) Continuous repetitive discharges

  • B) High amplitude spikes

  • C) High frequency oscillations

  • D) EEG seizures with no clinical signs

• Q.3 When comparing subdural and sterotactic depth electrodes, which of the following is false?

  • A) Subdural electrodes may afford more extensive mapping of eloquent cortex

  • B) Sterotactic depth electrodes may afford more precise recording from deeper regions away from the cortical surface

  • C) Subdural electrodes have a lower risk of complications than sterotactic depth electrodes

  • D) Subdurals are more difficult to explant

• Q.4 At one year after resective epilepsy surgery, factors favorable for consideration of medication withdrawal include which of the following?

  • A) No postoperative seizures

  • B) No epileptiform discharges on EEG

  • C) No mitigating factors suggesting incomplete resection

  • D) All of the above

• Q.5 Which antiepileptic drug regimen combines drugs with different mechanisms of action?

  • A) Lamotrigine + Carbamazepine

  • B) Lamotrigine + Eslicarbazepine

  • C) Phenytoin + Carbamazepine

  • D) Lamotrigine + Clobazam

• Q.6 Which of the following conditions has been identified as a highest risk factor for non-convulsive status epilepticus?

  • A) Coma in the setting of intracerebral hematoma

  • B) History of bipolar disorder

  • C) Acute ischemic stroke

  • D) Liver failure

• Q.7 What is the approximate percentage of patient with altered mental status found to be having seizures on EEG in the ICU?

  • A) 1–5%

  • B) 20–30%

  • C) 80–90%

  • D) 70–80%

• Q.8 Which ICU EEG application can help detect seizures and display multiple hours of EEG on a single screen?

  • A) Quantitative EEG (Trend Analysis)

  • B) High frequency oscillations

  • C) Magnetoencephalography (MEG)

  • D) Using EEG filters

  Using silver epoxide coated plastic electrodes All of the above

• Q.9 All except which of the following interventions may help to reduce the risk for suicide in youths with epilepsy?

  • A) Ask directly about mood and suicidal ideation at clinic visits

  • B) Perform mental health screening at least every 6 months or with treatment changes

  • C) Avoid discussing suicide with suggestible teens

  • D) Sending all to psychiatry OPD

• Q.10 All of the following are true regarding contraception in women with epilepsy EXCEPT which of the following?

  • A) Estrogen activates seizures in one third of women with epilepsy

  • B) Oral hormonal contraception inhibits the metabolism of lamotrigine

  • C) Enzyme-inducing antiepileptic medications are associated with increased risk of oral contraceptive failure

  • D) Intrauterine device is preferred in those with one child.