EEG ICU and Continuous EEG Monitoring 4

Question 1

Which EEG pattern in a comatose patient is most associated with nonconvulsive status epilepticus (NCSE)?

Accepted Answer

Rhythmic or periodic discharges evolving in frequency or morphology

Answer

Burst suppression with flat interburst intervals

Answer

Diffuse slowing with theta predominance

Answer

Alpha coma pattern with unreactive background

Question 2

In continuous EEG monitoring, what is the recommended minimum duration of recording to detect the majority of seizures in high-risk ICU patients?

Accepted Answer

24 hours

Answer

2 hours

Answer

6 hours

Answer

48 hours

Question 3

A patient post-cardiac arrest shows an EEG with suppression-burst ratio >50% and identical burst morphology across channels. What does this suggest?

Accepted Answer

Severe diffuse cortical injury with poor prognosis

Answer

Favorable prognosis for neurological recovery

Answer

Therapeutic hypothermia artifact

Answer

Focal cortical dysplasia

Question 4

Which quantitative EEG (qEEG) trend is most useful for detecting secondary cerebral ischemia in subarachnoid hemorrhage patients?

Accepted Answer

Relative alpha variability (RAV)

Answer

Burst suppression ratio

Answer

Epileptiform discharge index

Answer

Interhemispheric coherence

Question 5

When interpreting cEEG in a patient receiving midazolam infusion, which pattern is expected and should not be mistaken for pathology?

Accepted Answer

Diffuse beta activity with spindle-like waveforms

Answer

Frontal intermittent rhythmic delta activity (FIRDA)

Answer

Triphasic wave morphology

Answer

Vertex sharp waves

Question 6

A continuous EEG shows lateralized periodic discharges (LPDs) at 2 Hz in a patient with herpes simplex encephalitis. What is the significance of LPDs in this context?

Accepted Answer

They indicate ictal or interictal activity and require antiseizure consideration

Answer

They confirm the diagnosis of HSV encephalitis

Answer

They represent a benign artifact from electrode impedance mismatch

Answer

They are pathognomonic for focal cortical dysplasia

Question 7

Which electrode placement is most critical to include when performing cEEG specifically to detect subcortical or deep seizure activity in ICU patients?

Accepted Answer

Temporal chain electrodes (T3, T4, T5, T6)

Answer

Nasopharyngeal or sphenoidal electrodes

Answer

Midline electrodes (Fz, Cz, Pz)

Answer

Ear reference electrodes (A1, A2)