ABPN ABPN Epilepsy and Seizure Disorders 1 — Questions and Answers
Question 1: According to the 2017 ILAE classification, which of the following is correctly categorized as a focal seizure type?
- Absence seizure
- Tonic-clonic seizure
- Focal aware seizure (Correct answer)
- Myoclonic seizure
Correct answer: Focal aware seizure
Focal aware seizure is the updated ILAE 2017 term for what was previously called a simple partial seizure, indicating preserved awareness during the event.
Question 2: What EEG pattern is most characteristic of childhood absence epilepsy?
- Hypsarrhythmia
- 3 Hz generalized spike-and-wave discharges (Correct answer)
- Periodic lateralized epileptiform discharges (PLEDs)
- Burst-suppression pattern
Correct answer: 3 Hz generalized spike-and-wave discharges
Childhood absence epilepsy classically produces 3 Hz generalized spike-and-wave discharges on EEG, often triggered by hyperventilation.
Question 3: Which is the most common cause of new-onset epilepsy in adults over 60 years of age?
- Genetic epilepsy syndromes
- Traumatic brain injury
- Cerebrovascular disease (Correct answer)
- CNS tumors
Correct answer: Cerebrovascular disease
Cerebrovascular disease (stroke) is the leading identifiable cause of epilepsy in older adults, accounting for approximately 30-40% of cases.
Question 4: A 22-year-old has brief morning myoclonic jerks shortly after awakening and occasional generalized tonic-clonic seizures. Which epilepsy syndrome is the most likely diagnosis?
- Lennox-Gastaut syndrome
- Juvenile myoclonic epilepsy (Correct answer)
- Childhood absence epilepsy
- Dravet syndrome
Correct answer: Juvenile myoclonic epilepsy
Juvenile myoclonic epilepsy (JME) classically presents in adolescence or young adulthood with myoclonic jerks on awakening, generalized tonic-clonic seizures, and absence seizures.
Question 5: Which seizure type is characterized by a sudden loss of postural muscle tone, often causing the patient to fall?
- Myoclonic seizure
- Tonic seizure
- Clonic seizure
- Atonic seizure (Correct answer)
Correct answer: Atonic seizure
Atonic seizures (drop attacks) involve sudden loss of muscle tone, causing abrupt falls; they are associated with Lennox-Gastaut syndrome.
Question 6: According to current operational guidelines, status epilepticus is defined as a seizure lasting at least how long, or two seizures without return to baseline?
- 2 minutes
- 5 minutes (Correct answer)
- 10 minutes
- 30 minutes
Correct answer: 5 minutes
Current guidelines (Trinka et al., 2015) define status epilepticus operationally as a seizure lasting ≥5 minutes or two or more seizures without recovery of consciousness between them.
Question 7: Which neuroimaging modality is considered the gold standard for structural evaluation in patients with epilepsy?
- CT scan with contrast
- PET scan
- MRI brain with epilepsy protocol (Correct answer)
- SPECT scan
Correct answer: MRI brain with epilepsy protocol
MRI with an epilepsy-specific protocol (thin cuts, FLAIR, T1 volumetric) is the gold standard for detecting structural abnormalities such as hippocampal sclerosis, cortical dysplasia, and tumors.
ABPN ABPN Epilepsy and Seizure Disorders 1
According to the 2017 ILAE classification, which of the following is correctly categorized as a focal seizure type?