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ABRET EEG Exam (New 2024/ 2025 Update) Qs

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which of the following extra electrodes might best demonstrate the EEG activity associated with focal motor twitching of the right corner of the mouth? - ANSWER C sphenoidal electrodes are used to record activity from the - ANSWER anterior temporal lobes what additional electrodes could be placed to help decipher between artifact and cortical activity - ANSWER EOG electrodes what type of monitoring would be useful in an EEG with a patient experiencing syncope? - ANSWER ECG an abbreviated 10-20 placement, respiration, ECG and EOG monitors should be used when recording - ANSWER neonates what additional monitoring should be done in a middle age patient who repeatedly alerts from sleep during the EEG? - ANSWER Respiration brain abscess - ANSWER focal polymorphic delta activity Cortical EEG recordings can be obscured in patients who are tense and anxious due to - ANSWER myogenic artifact which combination of settings will help enhance a low voltage slow wave that is being masked by muscle activity? - ANSWER Sen 5; LF .3; HF 35

to enhance the background alpha and beta asymmetry in an EEG record showing moderately high voltage delta activity, the tech should use a - ANSWER shorter time constant and increased sensitivity A waveform of 0.5 Hz can be best enhanced with a filter of - ANSWER LF 0.3 Hz of the following, the BEST choice of reference to be used when recording in suspected temporal lobe epilepsy is - ANSWER CZ Which montage would be best to localize occipital spikes by phase reversal? - ANSWER circumferential bipolar montage When using the average reference, if a spike-and-wave focus appears at C3, the abnormality would be best enhanced by - ANSWER excluding C3 and surrounding electrodes from reference which of the following montages would best display the amplitude of a left temporal spike - ANSWER left temporal to the contralateral ear when attempting to minimize relentless muscle artifact on a recording, the tech should be aware that lowering the high filter could cause the artifact to resemble - ANSWER beta activity Referential recording is most appropriate for measuring - ANSWER voltage which of the following settings could be used to reduce the effects of sweat artifact in a patient with asymmetrical low-voltage fast activity? - ANSWER - S = 5 microvolts/mm

• LF = 5 Hz
• HF = 70 Hz which of the following is the most appropriate instrumentation setting change that should be made in order to enhance cortical slowing? - ANSWER Change the LFF from 1 Hz to .1 Hz Fourteen and six Hz positive spikes are best recorded with - ANSWER the contralateral ear reference

The best reference electrode in an awake patient with excessive temporal myogenic activity would be - ANSWER Cz A slow wave focus is best seen with - ANSWER LF 0.3 Hz, paper speed 15 mm/sec Laplacian montage - ANSWER source reference derivation EEG amplifiers work on the principle(s) of - ANSWER differentiation and amplification Doubling the inter-electrode distances will have what effect on the waveforms? - ANSWER increase amplitude term used to describe the. way a signal is sampled at intervals and assigned a numeric value - ANSWER sampling rate Digital EEG montages are reformatted by using - ANSWER system reference Input impedance should be - ANSWER very high Low sampling rate may cause fast frequencies to appear slower: - ANSWER aliasing 2016 ACNS guidelines recommends a CMRR of at least: - ANSWER 90 dB which of the following sites is most commonly used for the ground electrode in EEG - ANSWER Fpz For low frequency filters (LFFs), the corresponding time constants for LFF cutoff frequency of 3 Hz would be - ANSWER 0.05 seconds frequency response curve - ANSWER filters

Vertical resoution - ANSWER amplitude common mode rejection - ANSWER differential amplifier A 0.3 Hz wave would be attenuated by what percentage with a 0.3 Hz filter? - ANSWER 0. long time constant - ANSWER LFF of .1 hz Signals common to both inputs of a differential amplifier with like frequency, amplitude and phase are: - ANSWER canceled undersampling - ANSWER Aliasing With high frequency filtering, muscle artifact may become distorted and look like - ANSWER beta activity all of the following factors favor cancellation of signals in two inputs of the amplifier, except - ANSWER unequal impedances in the inputs The sharpness of the frequency response curve is determined by the filter - ANSWER rolloff The ability of an amplifier to reject like signals. - ANSWER common mode rejection In a differential amplifier, if input 1 recvied a voltage if + 50 mv and input 2 a voltage of - 100 mv, the output voltage and deflection would be - ANSWER 150 downward which of the following time constants would best display beta activity - ANSWER 1.0 seconds 2016 ACNS guidelines recommends a minimum horizontal resolution of - ANSWER 16 bits a time constant of 0.5 sec - ANSWER high pass filter of 0.3 hz

for a high frequency filter setting of 70hz, the nyquist frequency is? - ANSWER 140 samples per sec Gradual changes in the frequency of diseases over long periods are known as: - ANSWER evolution which of the following is not useful in digital EEG recordings - ANSWER bio calibration A device that alters the amplitude of specific frequencies of a signal- - ANSWER filter the amount by which differential amplifiers increases the magnitude of the input signal is it's - ANSWER sensitivity which mathematically converts the time function into a sine wave of different frequencies - ANSWER fast fourier transform High data sampling rates in a digital EEG machine create - ANSWER smooth, connected lines what percentage of actual amplitude will be visible of 15 Hz wave when using a HFF setting of 15 Hz? - ANSWER 0. the 60 hz notch filter will have the greatest effect on a waveform having duration of - ANSWER 16 msec which of the following most closely relates to the ratio of an amplifiers output to input signal? - ANSWER system gain Voltage resolution - ANSWER analog to digital converter Frequency - ANSWER influenced by sampling rate and measured in Hertz what happens when a 60 cycle sine wave is sampled at 100 hertz - ANSWER aliasing

time constant - ANSWER Low Frequency Filter Clipping of the waveforms occurs when: - ANSWER the signal is outside the range of the digitizer A 0.5Hz wave is enhanced without affecting a spike by using - ANSWER LF 0.3 HZ which of the following time constants would best display delta activity? - ANSWER 1.0 seconds all of the following factors favor cancellation of signals in the two inputs of an amplifier, except - ANSWER unequal impedances in the inputs bilateral anterior beta activity is most likely to occur with - ANSWER diazepam Triphasic waves and/or periodic discharges can be present on an EEG due to the toxic effects of which of the following medication? - ANSWER lithium which of the following drugs exhibits the most observable effect on the EEG? - ANSWER benzodiazepines at therapeutic levels, phenytoin causes what kind of EEG findings? - ANSWER no change Phenobarbital - ANSWER beta activity what is the most prominent clinical feature of dilantin toxicity - ANSWER ataxia what is the most common cause of generalized beta? - ANSWER medications ORDA is commonly seen in children with - ANSWER absence seizures

what is the name of the artifact that appears as a prominent R wave with positivity over the left posterior quadrant of the head and can resemble spikes? - ANSWER ECG artifact sweat artifact - ANSWER slow deflection Artifact that is caused by movement of people near the patient: - ANSWER electrostatic artifact which of the following would be considered an abnormal EEG presentation to photic stimulation? - ANSWER photo paroxysmal Sub-harmonic photic driving response - ANSWER half the frequency of the flash strobe Hyperventilation - ANSWER hypocapnia An EEG obtained during sleep is of most value in which condition? - ANSWER complex partial seizures what could be the cause for build-up if slowing several minutes after the hyperventilation has been completed? - ANSWER moya moya disease Atypical Photic Response - ANSWER Delta Driving Photic stimulation is most effective in evoking epileptiform abnormalities in patients with - ANSWER a family history of seizures Photic induced epileptic discharges are most likely associated with: - ANSWER barbiturate withdrawal An asymmetric photic driving response right greater than left is: - ANSWER a common finding which of the following is most useful in the evaluation of temporal lobe seizures - ANSWER Sleep EEG

The EEG finding during REM sleep - ANSWER saw tooth waves what waveform is seen in stage 2 sleep and during arousal, and contains 3 components, sharp, slow and fast - ANSWER k complex STAGE N3 SLEEP - ANSWER 30% delta activity At what age is hypnagogic hypersynchrony most prominent - ANSWER 2-6 years old what is the most common frequency of sleep spindles - ANSWER 14 Hz Low amplitude 11-14 Hz, 1-2 sec duration, maximal in central regions: - ANSWER sleep spindles NARCOLEPSY - ANSWER sleep-onset REM Rare 6-11 hz negative sharp arciform waves, most commonly seen in adults over 30 years in the mid- temporal regions. - ANSWER wickets which pattern is most likely to be seen during prolonged recordings of normal awake 30 year old - ANSWER lambda Mu Rhythm - ANSWER C3-C Mu rhythm and alpha rhythm differ from each other in all of the following respects EXCEPT - ANSWER frequency What do Mittens, midline rhythmic theta, and Trace alternans have in common? - ANSWER they are all normal waveforms a uncommon, but normal variant seen in adults 50 and older that may be mistaken for epileptiform activity - ANSWER SREDA

The EEG is most likely to show a hypsarrhythmia pattern in patients with - ANSWER West syndrome which of the following would indicate the best prognosis in a comatose patient? - ANSWER electrographic changes indicating wakefulness and sleep Slow spike-and-wave complexes are characteristic of: - ANSWER Lennox-gaustaut syndrome An underlying lesion of white matter will more likely result in: - ANSWER focal slowing what clinical states may cause the alpha rhythm to attenuate? - ANSWER all are correct PLEDs are NOT typically seen in patients with - ANSWER Lennox-Gastaut An EEG obtained within 24 hours following a closed head injury would be LEAST likely to show - ANSWER focal spike activity The waveform morphology during the clonic phase of a GTC may present as - ANSWER spike and slow wave - rhythmic generalized Subacute sclerosing panencephalitis is associated with - ANSWER measles high amplitude spikes in the occipital region, time locked with a slow photic stimulus rare in young children is a characteristic of which of the following diseases? - ANSWER Batten's disease Creutzfeldt-Jakob disease - ANSWER GPD's/GPEDS which of the following tumors is most likely to provoke EEG abnormalities - ANSWER glioblastoma

a degenerative disease characterized by dementia, and dance like movements - ANSWER Huntington's chorea WORST prognostic feature in the EEG of a comatose patient - ANSWER mono rhythmic tracing without variability Typical EEG pattern associated with absence seizures - ANSWER 3 Hz spike and wave In a beeping coma, trihphasic waves are most likely to - ANSWER disappear Hypsarrhythmia - ANSWER infantile spasms Landau-Kleffner Syndrome - ANSWER Aphasia-loss of ability to understand or express speech The EEG of a child with benign rolandic epilepsy is most likely to show: - ANSWER C3 spikes Localized or lateralized high voltage delta: - ANSWER cerebral abscess Very high voltage, generalized, but anterior-dominant fast activity appearing as continuous sleep spindles sometimes found in mental retardation has been referred to as: - ANSWER Extreme spindles A majority of patients with arterial hypertension and acute pure motor hemiplegia an EEG will most likely show - ANSWER normal activity Benign Rolandic Epilepsy - ANSWER central-temporal spikes EEG pattern characteristic of West syndrome - ANSWER hypsarrthymia Occipital spikes in response to low frequency flashes are commonly seen in what conditions? - ANSWER batten's disease

a 60 year old male presents with new onset dementia and myoclonus, what would you expect to see on the EEG - ANSWER GPD's Meningitis - ANSWER nuchal rigidity Represents a poor prognosis. - ANSWER alpha coma EEG of Lennox-Gastaut Syndrome - ANSWER 1.5 Hz spike and wave discharges the interictal EEG of children with a HX of untreated febrile seizures is usually - ANSWER normal Eyelid myoclonia with absences, eye closure induced seizures, EEG paroxysms and photosensitivity: - ANSWER jeavon's syndrome The EEG is always abnormal in - ANSWER Herpes simplex encephalitis what effects might be seen on an EEG performed on a patient with chromic alcoholism - ANSWER low amplitude and decreased alpha ADA - ANSWER arrhythmic delta activity which of the following represents an abnormal EEG pattern - ANSWER alpha frequency of 9hz in 01 and 11.5 hz in 02 the prevalent activity seen in the adult EEG recording is indicative of - ANSWER encephalopathy what percentage of adults have asymmetrical alpha - ANSWER 60% Which normal waveform is NOT typically seen in the posterior leads? - ANSWER Wickets

when the posterior background rhythm does not attenuate with eye opening its referred to as - ANSWER bancaud phenomenon EEG with a very tense and anxious patient shows - ANSWER widespread low voltage activity what would you expect to see in the frontal regions of a normal adult - ANSWER low voltage fast activity and eye movement artifact Normal EEG In adults of 70 or older is similar to those younger with the following exception - ANSWER REM sleep is less than 20% of total sleep time LPD's - ANSWER lateralized periodic discharges an abrnormal EEG finding in an awake 55 year old patient would be - ANSWER delta activity If an 8 year old child develops high voltage bilateral delta activity maximal in the posterior regions during hyperventilation, it most likely indicates - ANSWER normal hyperventilation response infantile spams - ANSWER electrodecremental event High voltage theta or delta waves, commonly seen in children 8-14 years, accentuated by hyperventilation: - ANSWER posterior slow waves of youth PSWY which of the following is the most likely posterior dominant rhythm in an awake 5-month old infant - ANSWER 5 Hz by which of the following ages should EEG differentiation of the four stages of non-rem sleep be identifiable in a child born at term - ANSWER 6 months sleep spindles should be synchronous by - ANSWER 2 years

Vertex waves in pediatric EEG recordings are generally: - ANSWER sharper The interictal EEG of children with a history of untreated febrile seizures usually is - ANSWER normal Which encephalopathic EEG pattern is most commonly associated with children? - ANSWER OIRDA a posterior dominant rhythm reactive to eye closure first appears around - ANSWER 3-6 months Asynchrony of sleep spindles is abnormal after: - ANSWER 2 years seen most often in children - ANSWER Rolandic spikes By one year of age the dominant background rhythm should be - ANSWER 5-6 Hz In a 38-week conceptional age infant, which of the following would be considered abnormal? - ANSWER left hemisphere voltage suppression in a normal 28-week pre-term infant, the EEG should show what type of pattern - ANSWER Trace' Discontinu the pattern which appears at the youngest post menstrual age is? - ANSWER delta brushes Sleep stages in a term newborn infant are - ANSWER characterized by rapid onset active sleep At what conceptional age would you expect delta brushes to no longer be present - ANSWER 44CA Delta brushes are seen in what type of patients? - ANSWER premature infants

in a 27 week gestational age neonate, where are delta brushes expected to be seen most prominently - ANSWER central delta brushes are seen in - ANSWER neonate, quiet sleep TRACE ALTERNANT - ANSWER 35 weeks conceptual age Temporal theta burst is an EEG feature seen in which neonatal age group? - ANSWER 24-28 weeks gestation A neonatal EEG showing eye movements, body twitches, absent chin myogram, and irregular respirations confirms the patient is in what state? - ANSWER active sleep right temporal sharp transients recorded during wakefulness in a 38 week conceptual age infant - ANSWER in a non specific indicator of right temporal dysfunction At the onset of sleep, a 40-week conceptional age infant is most likely to enter into which of the following stages of sleep? - ANSWER Active At what conceptional age is a delta brush pattern primarily seen? - ANSWER 32-34 weeks If the EEG of a term newborn with asphyxia shows nonreactivity and periods of severe attenuation with bursts of mixed activity every 10 to 20 seconds, which of the following is MOST likely indicated? - ANSWER severe cortical injury due hypoxic-ischemic encephalopathy which of the following is most likely to be the finding in a full term neonate with seizures - ANSWER focal spike and sharp waves which of the following is normal pattern found at about 32 weeks conceptional age - ANSWER delta brush

A pattern of 1 to 1.5 Hz activity with superimposed 8 to 20 Hz activity seen in neonates is called - ANSWER delta brush This neonate pattern is associated with interburst intervals that are less than 25 uV in amplitude and are expected up to 34 weeks postmenstrual age. - ANSWER Trace' Discontinu At what age do encoches frontales first appear? - ANSWER 34-37 weeks CA which of the following is a random disorganized pattern characterized by extremely high voltage activity with slow waves and multifocal spikes seen with infantile spasms - ANSWER hypsarrthymia During an ECI recording, what is the highest sensitivity that must be included in the recording? - ANSWER 2uV/mm According to the Adult ACNS EEG Terminology, a pattern that is bilateral, bisynchronous and asymmetric, even if It has a restricted field, it termed - ANSWER generalized According to the ACNS guidelines, EEG recordings should include a minimum of __ channels and ___ electrodes - ANSWER 16; According to the ACNS guidelines, EEG recordings should include a minimum of __ channels and ___ electrodes - ANSWER 16; Periodic discharges - ANSWER Seen at nearly regular intervals and having a cycle length varying by less than 50% negative polarity - ANSWER triphasic waves No difference in voltage between input 1 and input 2 - ANSWER equipotential a downward deflection occurs if - ANSWER input 1 is more positive than input 2

what is most useful when determining localization and polarity - ANSWER montage positive polarity - ANSWER lambda the polarity convention for EEG states that the deflection is up if - ANSWER Input 1 is more negative than input 2 In an EEG a surface-negative wave will appear as: - ANSWER Either an upward or downward deflection in a referential montage localization is determined by - ANSWER amplitude which of the following is one of the 10 ACNS guidelines for ECI recordings - ANSWER use of double distance montages of the following, which is NOT an ACNS guideline for ECI recording. - ANSWER Record the standard sensitivity of 7uV/mm for at least 30 minutes. what is the duration of a 10 Hz wave at a display of 15 mm/seconds - ANSWER 100 sec a 9mm deflection at a setting of 20 microvolts/mm will have an input signal of - ANSWER 180 microvolts high voltage transient with a duration of 2mm - ANSWER spike sharp wave - ANSWER 70-200 msec VOLTAGE - ANSWER V = SD 1 centimeter - ANSWER 10 millimeters

what is the voltage of a spike if it measures 15mm peak to peak and the sensitivity value is 10 microvolts/mm - ANSWER 150 microvolts ALPHA COMA - ANSWER cardiopulmonary arrest patients with temporal lobe epilepsy may display ictal automatisms, which are - ANSWER stereotyped, repetitive movements, such as lip smacking or rubbing fingers together. the tonic phase of a generalized tonic-clonic seizure is associated with - ANSWER low voltage rhythmic beta during which of the following types of seizures would a patient be likely to experience deja vu? - ANSWER complex partial Periodic lateralized epileptiform discharges are most commonly in the EEG's of patients with - ANSWER acute cerebral infarction Beta coma most commonly results from: - ANSWER drug overdose which of the following is most characteristic of complex partial seizures - ANSWER diffuse rhythmic spikes followed by diffuse SSW activity ALPHA COMA - ANSWER cardiac arrest a seizure discharge arising from the right frontal lobe is likely to be characterized clinically by - ANSWER deviation of head and eyes Excessive beta frequency activity may be the result of which of the following? - ANSWER skull breach EMG artifacts time locked with the flash frequency of photic stimulation - ANSWER Photomyogenic response

SKULL DEFECT - ANSWER Breach rhythm in patients with myoclonic epilepsy of Janz, seizures are most likely to occur - ANSWER early in the morning which neurologic syndrome may be associated with focal epilepsy - ANSWER tuberous sclerosis complex Delta bursts that reappear 3 to 5 minutes after cessation of HV is a common feature in which of the following diseases? - ANSWER moyamoya disease An electrographic seizure is characterized by - ANSWER Episodic rhythmic activity Anoxic encephalopathy - ANSWER BIPLEDS what feature is most diagnostic of PNES - ANSWER no disruption of the PDR Alpha coma is most often seen following: - ANSWER cardiac arrest which of the following EEG pattern is MOST likely associated with seizures - ANSWER TIRDA Rhythmic theta activity in the temporal region is most commonly associated with which seizure type? - ANSWER complex partial what is the term that best describes failure of the alpha rhythm to attenuate with eye opening - ANSWER Bancaud's phenomenon hypothalamic hamartoma - ANSWER Gelastic seizure Landau-kleffner syndrome is characterized by - ANSWER electrical status epilepticus of sleep

PARTIAL SEIZURE DISORDER - ANSWER anterior temporal spike focus A common electrographic correlate of a seizure: - ANSWER rhythmic activity which pattern is not the result of cerebral anoxia - ANSWER phantom spike and wave a prolonged series of generalized convulsions without any period of consciousness between them is refereed to as - ANSWER status epilepticus which of the following is the most common EEG correlate of an epileptic aura - ANSWER temporal epileptiform discharges a 14 year old female with a history of "body jerks" in the morning presents first time seizure, what would you expect to see on the EEG - ANSWER 3-6 hz generalized polyspike and wave Immediately following a generalized tonic clonic seizure- the EEG typically shows - ANSWER generalized slowing Photomyogenic response may be enhanced by: - ANSWER alcohol or barbiturate withdrawal An EEG technologist observes what appears to be both Mu Rhythm and posterior dominant rhythm at the same time during the live EEG. What can they do to prove that the rhythm is Mu? - ANSWER ask the patient to move their contralateral hand Alpha coma - ANSWER 8-13 Hz activity occuring diffusely, maximum anteriorly Photoparoxysmal response are characterized by - ANSWER Generalized irregular spike and wave discharges or polyspike and burst which of the following patterns is characterisitically eliminated by movement of a limb - ANSWER Mu Rhythm

what would be considered a focal abnormality - ANSWER Unilateral spikes SREDA most often seen - ANSWER suddenly in resting EEG BIPLEDS - ANSWER hypoxia during neonatal seizures, the EEG is most likely to show - ANSWER focal rhythmic activity SMALL SHARP SPIKES - ANSWER benign epileptiform transients of sleep saccadic eye movement - ANSWER Lambda benign epileptiform transients of sleep - ANSWER peak at 30-60 years most diagnostic value - ANSWER asymmetric frequency difference between posts and lambda - ANSWER occurs with eyes open triphasic waves - ANSWER they have a time lag from frontal to posterior head regions Morphology, location and frequency are ways to describe - ANSWER EEG patterns and seizures Bilateral Synchrony - ANSWER reflects rapid generalization from one or multiple sources Mu Rhythm - ANSWER 8-10 Hz it is common foe FIRDA to - ANSWER react to stimulation

Rhythmic theta activity in the temporal region is most commonly associated with which seizure type? - ANSWER complex partial