The Commonest Neurological Complication After VNS

The Commonest Neurological Complication After VNS
The Commonest Neurological Complication After VNS
1. Which one of the following is the commonest neurological complication after VNS?
a. Arrhythmia
b. Bradycardia
c. Dysphonia
d. Facial numbness
e. Hypotension
2. A 10-year-old child undergoes hemispherectomy. At 2 years post-op, he is only having
nocturnal seizures now. Which one of the
following Engel Epilepsy surgery outcome
classes does he fall into?
a. I
b. II
c. III
d. IV
e. V
3. Which one of the following is an unlikely primary indication for using invasive EEG monitoring as part of evaluation for epilepsy
surgery?
a. Seizure onsets are lateralized but not
localized
b. Seizure onsets are localized but not clearly
lateralized (i.e. bilateral)
c. Seizure onset near eloquent cortex however unknown focus
d. Dual pathology in opposite hemispheres
e. Multiple cortical lesions (e.g. tuberous
sclerosis)
f. Predicting postoperative memory deficit
4. A 29-year-old man with a history of
febrile seizures as a child has developed
medication-refractory complex partial
seizures within the past 2 years. EEG suggests a left temporal focus, with evidence of
concordant PET imaging. An MRI as shown
below, reveals the abnormality. Which one of
the following is the next appropriate step in
management?
A B
a. Depth electrodes
b. Subdural grid
c. Subdural strip
d. AVM resection
e. Temporal lobectomy
5. A 49-year-old woman is referred with a 1-year
history of medically refractory epilepsy. Electrographically, both interictally and ictally, this
patient’s seizures were consistent with left
mesial temporal onset. However, no definite
abnormalities were observed on MRI. Assuming left hemisphere dominance for language,
neuropsychological data were suggestive of left
temporal lobe dysfunction. Some intact verbal
memory scores raised a question that the left
mesial temporal lobe structures were intact.
Wada test: Language lateralized to the left
hemisphere. She underwent invasive electrocorticographic (ECoG) monitoring with a left
mesial temporal (LMT) strip, basal temporal
strips (anterior, LAT and posterior, LPT),
and an 88 electrode grid with the upper five
rows located frontoparietally (contacts 1-40)
and the lower three rows over the lateral temporal neocortex (contacts 41-64). All seizures
were electrographically stereotyped. Electrographic onset preceded clinical onset and consisted of fast activity of 80-100 Hz isolated to
the contact at LG41. Six to nine seconds later
this abruptly transitioned to a 2.5-Hz spike and
wave pattern involving the mesial and basal
temporal contacts.Which one of the following
statements is most accurate?
LAT LPT
LMT
1
9 17
25
33
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