EEG - Electroencephalography Pediatric and Neonatal EEG Questions and Answers

Question 1

An EEG is performed on a 32-week conceptional age premature infant.
During quiet sleep, the recording shows bursts of high-amplitude mixed frequencies lasting 3-10 seconds, separated by periods of marked attenuation (<25 µV) lasting 10-20 seconds.
This pattern is best described as:

Accepted Answer

Tracé discontinu

Answer

Tracé alternant

Answer

Burst-suppression

Answer

Hypsarrhythmia

Question 2

A 7-year-old child with normal development presents with new-onset seizures, often occurring shortly after falling asleep. The seizures involve twitching on one side of the face and drooling. The interictal EEG shows high-amplitude, diphasic sharp-and-slow wave complexes that are most prominent over the left centrotemporal region and increase significantly during drowsiness. What is the most likely diagnosis?

Accepted Answer

Self-Limited Epilepsy with Centrotemporal Spikes (SeLECTS)

Answer

Childhood Absence Epilepsy

Answer

Lennox-Gastaut Syndrome

Answer

Juvenile Myoclonic Epilepsy

Question 3

Which of the following electrographic features is most characteristic of an ictal event (electrographic seizure) in a full-term neonate?

Accepted Answer

A sustained, rhythmic, evolving pattern of sharp waves or delta activity lasting more than 10 seconds.

Answer

Generalized, synchronous 3 Hz spike-and-wave discharges.

Answer

Intermittent, asynchronous bursts of high-voltage slow waves mixed with spikes (Hypsarrhythmia).

Answer

Bilaterally synchronous and symmetric sleep spindles.

Question 4

A 6-month-old infant is brought in for evaluation of developmental regression and clusters of flexor spasms that occur upon waking. The EEG shows a continuous, chaotic, and disorganized pattern of very high-voltage, asynchronous slow waves with multifocal spikes and sharp waves. This EEG pattern is called:

Accepted Answer

Hypsarrhythmia

Answer

Burst-suppression

Answer

Tracé alternant

Answer

Extreme spindle coma

Question 5

In a healthy 3-year-old child, the posterior dominant rhythm (PDR) during relaxed wakefulness with eyes closed is expected to have a frequency of approximately:

Accepted Answer

8-9 Hz

Answer

4-5 Hz

Answer

10-12 Hz

Answer

6-7 Hz

Question 6

A 5-year-old girl is evaluated for frequent staring spells. During hyperventilation, the EEG shows a 12-second burst of generalized, synchronous, and symmetric 3 Hz spike-and-wave discharges with an abrupt onset and offset. The patient was unresponsive during the event. This EEG finding is the classic hallmark of:

Accepted Answer

Childhood Absence Epilepsy

Answer

Lennox-Gastaut Syndrome

Answer

Benign Rolandic Epilepsy

Answer

Juvenile Myoclonic Epilepsy