EEG BOARD PREP ASAP T Study Guide PDF |
Complete Electroencephalography
Certification Exam Review | R. EEG T Board Prep,
EEG Waveforms, Seizure Patterns, Epileptiform
Discharges, Artifact Recognition, Activation
Procedures & Clinical Correlations Bundle
Question 1: Which electrode placement in the International 10-20 System is located at the midpoint
between Fpz and Oz?
A. Cz
B. Fz
C. Pz
D. Iz
CORRECT ANSWER: A. Cz
RATIONALE: In the International 10-20 System, Cz is positioned at the vertex, precisely at the midpoint
of the line connecting Fpz (frontal pole midline) and Oz (occipital pole midline). This central midline
electrode serves as a critical reference point for montage construction and spatial localization of
cerebral activity.
Question 2: What is the standard paper speed used for routine clinical EEG recording in the United
States?
A. 15 mm/sec
B. 30 mm/sec
C. 60 mm/sec
D. 120 mm/sec
CORRECT ANSWER: B. 30 mm/sec
RATIONALE: The American Clinical Neurophysiology Society (ACNS) recommends 30 mm/sec as the
standard paper speed for routine EEG. This speed provides optimal temporal resolution for identifying
waveform morphology, frequency, and duration while maintaining practical recording length.
Question 3: Which frequency band defines alpha activity in a standard adult EEG?
A. 0.5–3 Hz
B. 4–7 Hz
C. 8–13 Hz
D. 14–30 Hz
CORRECT ANSWER: C. 8–13 Hz
RATIONALE: Alpha rhythm is defined as activity in the 8–13 Hz frequency range, typically maximal over
posterior regions in awake, relaxed adults with eyes closed. It attenuates with eye opening or mental
activity (alpha blockade), serving as a key marker of normal posterior dominant rhythm.
,EEG BOARD PREP ASAP T Study Guide PDF |
Complete Electroencephalography
Certification Exam Review | R. EEG T Board Prep,
EEG Waveforms, Seizure Patterns, Epileptiform
Discharges, Artifact Recognition, Activation
Procedures & Clinical Correlations Bundle
Question 4: During hyperventilation activation, which EEG change is considered a normal physiological
response in children and young adults?
A. Generalized spike-and-wave discharges
B. Posterior slow waves of youth
C. Bilateral high-amplitude delta slowing
D. Temporal sharp waves
CORRECT ANSWER: C. Bilateral high-amplitude delta slowing
RATIONALE: Hyperventilation induces cerebral vasoconstriction and mild hypoxia, commonly producing
bilateral, synchronous, high-amplitude delta slowing in children and young adults. This is a normal
activation response and should not be misinterpreted as pathological unless focal, persistent, or
associated with clinical symptoms.
Question 5: Which montage type displays the voltage difference between two adjacent scalp
electrodes?
A. Referential montage
B. Bipolar montage
C. Average reference montage
D. Laplacian montage
CORRECT ANSWER: B. Bipolar montage
RATIONALE: A bipolar montage displays the voltage difference between two adjacent electrodes in a
chain (e.g., Fp1-F3, F3-C3). This configuration enhances localization of focal abnormalities by
demonstrating phase reversal at the site of maximal voltage, aiding in spatial interpretation of
epileptiform or pathological activity.
Question 6: What is the recommended low-frequency filter (high-pass) setting for routine EEG
recording to minimize slow-wave artifact while preserving physiological delta activity?
A. 0.1 Hz
B. 0.3 Hz
C. 1.0 Hz
D. 5.0 Hz
CORRECT ANSWER: B. 0.3 Hz
,EEG BOARD PREP ASAP T Study Guide PDF |
Complete Electroencephalography
Certification Exam Review | R. EEG T Board Prep,
EEG Waveforms, Seizure Patterns, Epileptiform
Discharges, Artifact Recognition, Activation
Procedures & Clinical Correlations Bundle
RATIONALE: ACNS guidelines recommend a low-frequency filter of 0.3 Hz (time constant ≈ 0.5 sec) for
routine EEG. This setting attenuates very slow artifacts (e.g., sweat, movement) while preserving
physiological delta activity (0.5–4 Hz), critical for detecting encephalopathic or pathological slowing.
Question 7: Which EEG pattern is characterized by rhythmic 4–7 Hz activity maximal over temporal
regions, commonly seen in drowsy adults?
A. Mu rhythm
B. Lambda waves
C. Rhythmic temporal theta bursts of drowsiness (RTTBD)
D. Sleep spindles
CORRECT ANSWER: C. Rhythmic temporal theta bursts of drowsiness (RTTBD)
RATIONALE: RTTBD, also known as "psychomotor variant," consists of rhythmic 4–7 Hz theta activity
over mid-temporal regions during drowsiness. It is a benign, non-epileptiform pattern that should not be
misinterpreted as temporal lobe epilepsy, especially given its lack of evolution or clinical correlation.
Question 8: In a referential montage using linked ears as reference, what artifact may occur if one ear
electrode becomes disconnected?
A. Electrode pop artifact
B. Reference electrode artifact
C. Sweat artifact
D. EKG artifact
CORRECT ANSWER: B. Reference electrode artifact
RATIONALE: When using linked ears (A1+A2) as a common reference, disconnection or high impedance
in one ear electrode causes all channels referencing that ear to display large, synchronous artifacts. This
reference electrode artifact can mimic generalized abnormalities and underscores the importance of
checking reference integrity.
Question 9: Which of the following best describes the EEG correlate of Stage N2 non-REM sleep?
A. Alpha rhythm with vertex sharp waves
B. Sleep spindles and K-complexes
C. High-amplitude delta waves comprising >20% of the epoch
D. Low-voltage mixed-frequency activity with sawtooth waves
CORRECT ANSWER: B. Sleep spindles and K-complexes
, EEG BOARD PREP ASAP T Study Guide PDF |
Complete Electroencephalography
Certification Exam Review | R. EEG T Board Prep,
EEG Waveforms, Seizure Patterns, Epileptiform
Discharges, Artifact Recognition, Activation
Procedures & Clinical Correlations Bundle
RATIONALE: Stage N2 sleep is defined by the presence of sleep spindles (11–16 Hz, typically 12–14 Hz)
and/or K-complexes (high-amplitude biphasic waves) on a background of theta activity. These features
distinguish N2 from N1 (vertex waves, theta) and N3 (delta waves ≥20% of epoch).
Question 10: What is the minimum duration of electrographic seizure activity required for diagnosis of
nonconvulsive status epilepticus according to ACNS critical care EEG terminology?
A. 10 seconds
B. 30 seconds
C. 5 minutes
D. 10 minutes
CORRECT ANSWER: D. 10 minutes
RATIONALE: ACNS standardized critical care EEG terminology defines nonconvulsive status epilepticus as
electrographic seizures lasting ≥10 minutes, or recurrent seizures without return to baseline between
events. This duration threshold helps distinguish true status from brief ictal events and guides urgent
treatment decisions.
Question 11: Which artifact is characterized by rhythmic, sinusoidal waveforms at approximately 1 Hz
that correlate with the patient's pulse?
A. Respiratory artifact
B. EKG artifact
C. Pulse artifact
D. Glossokinetic artifact
CORRECT ANSWER: C. Pulse artifact
RATIONALE: Pulse artifact appears as rhythmic, sinusoidal slow waves (~1 Hz) time-locked to the cardiac
cycle, often maximal over frontal or temporal regions where electrodes overlie arteries. It results from
mechanical pulsation of blood vessels beneath the electrode and can be confirmed by simultaneous EKG
or pulse oximetry.
Question 12: In pediatric EEG, what is the expected posterior dominant rhythm frequency for a
normal 5-year-old child?
A. 3–4 Hz
B. 5–6 Hz
C. 7–8 Hz
D. 9–10 Hz
Complete Electroencephalography
Certification Exam Review | R. EEG T Board Prep,
EEG Waveforms, Seizure Patterns, Epileptiform
Discharges, Artifact Recognition, Activation
Procedures & Clinical Correlations Bundle
Question 1: Which electrode placement in the International 10-20 System is located at the midpoint
between Fpz and Oz?
A. Cz
B. Fz
C. Pz
D. Iz
CORRECT ANSWER: A. Cz
RATIONALE: In the International 10-20 System, Cz is positioned at the vertex, precisely at the midpoint
of the line connecting Fpz (frontal pole midline) and Oz (occipital pole midline). This central midline
electrode serves as a critical reference point for montage construction and spatial localization of
cerebral activity.
Question 2: What is the standard paper speed used for routine clinical EEG recording in the United
States?
A. 15 mm/sec
B. 30 mm/sec
C. 60 mm/sec
D. 120 mm/sec
CORRECT ANSWER: B. 30 mm/sec
RATIONALE: The American Clinical Neurophysiology Society (ACNS) recommends 30 mm/sec as the
standard paper speed for routine EEG. This speed provides optimal temporal resolution for identifying
waveform morphology, frequency, and duration while maintaining practical recording length.
Question 3: Which frequency band defines alpha activity in a standard adult EEG?
A. 0.5–3 Hz
B. 4–7 Hz
C. 8–13 Hz
D. 14–30 Hz
CORRECT ANSWER: C. 8–13 Hz
RATIONALE: Alpha rhythm is defined as activity in the 8–13 Hz frequency range, typically maximal over
posterior regions in awake, relaxed adults with eyes closed. It attenuates with eye opening or mental
activity (alpha blockade), serving as a key marker of normal posterior dominant rhythm.
,EEG BOARD PREP ASAP T Study Guide PDF |
Complete Electroencephalography
Certification Exam Review | R. EEG T Board Prep,
EEG Waveforms, Seizure Patterns, Epileptiform
Discharges, Artifact Recognition, Activation
Procedures & Clinical Correlations Bundle
Question 4: During hyperventilation activation, which EEG change is considered a normal physiological
response in children and young adults?
A. Generalized spike-and-wave discharges
B. Posterior slow waves of youth
C. Bilateral high-amplitude delta slowing
D. Temporal sharp waves
CORRECT ANSWER: C. Bilateral high-amplitude delta slowing
RATIONALE: Hyperventilation induces cerebral vasoconstriction and mild hypoxia, commonly producing
bilateral, synchronous, high-amplitude delta slowing in children and young adults. This is a normal
activation response and should not be misinterpreted as pathological unless focal, persistent, or
associated with clinical symptoms.
Question 5: Which montage type displays the voltage difference between two adjacent scalp
electrodes?
A. Referential montage
B. Bipolar montage
C. Average reference montage
D. Laplacian montage
CORRECT ANSWER: B. Bipolar montage
RATIONALE: A bipolar montage displays the voltage difference between two adjacent electrodes in a
chain (e.g., Fp1-F3, F3-C3). This configuration enhances localization of focal abnormalities by
demonstrating phase reversal at the site of maximal voltage, aiding in spatial interpretation of
epileptiform or pathological activity.
Question 6: What is the recommended low-frequency filter (high-pass) setting for routine EEG
recording to minimize slow-wave artifact while preserving physiological delta activity?
A. 0.1 Hz
B. 0.3 Hz
C. 1.0 Hz
D. 5.0 Hz
CORRECT ANSWER: B. 0.3 Hz
,EEG BOARD PREP ASAP T Study Guide PDF |
Complete Electroencephalography
Certification Exam Review | R. EEG T Board Prep,
EEG Waveforms, Seizure Patterns, Epileptiform
Discharges, Artifact Recognition, Activation
Procedures & Clinical Correlations Bundle
RATIONALE: ACNS guidelines recommend a low-frequency filter of 0.3 Hz (time constant ≈ 0.5 sec) for
routine EEG. This setting attenuates very slow artifacts (e.g., sweat, movement) while preserving
physiological delta activity (0.5–4 Hz), critical for detecting encephalopathic or pathological slowing.
Question 7: Which EEG pattern is characterized by rhythmic 4–7 Hz activity maximal over temporal
regions, commonly seen in drowsy adults?
A. Mu rhythm
B. Lambda waves
C. Rhythmic temporal theta bursts of drowsiness (RTTBD)
D. Sleep spindles
CORRECT ANSWER: C. Rhythmic temporal theta bursts of drowsiness (RTTBD)
RATIONALE: RTTBD, also known as "psychomotor variant," consists of rhythmic 4–7 Hz theta activity
over mid-temporal regions during drowsiness. It is a benign, non-epileptiform pattern that should not be
misinterpreted as temporal lobe epilepsy, especially given its lack of evolution or clinical correlation.
Question 8: In a referential montage using linked ears as reference, what artifact may occur if one ear
electrode becomes disconnected?
A. Electrode pop artifact
B. Reference electrode artifact
C. Sweat artifact
D. EKG artifact
CORRECT ANSWER: B. Reference electrode artifact
RATIONALE: When using linked ears (A1+A2) as a common reference, disconnection or high impedance
in one ear electrode causes all channels referencing that ear to display large, synchronous artifacts. This
reference electrode artifact can mimic generalized abnormalities and underscores the importance of
checking reference integrity.
Question 9: Which of the following best describes the EEG correlate of Stage N2 non-REM sleep?
A. Alpha rhythm with vertex sharp waves
B. Sleep spindles and K-complexes
C. High-amplitude delta waves comprising >20% of the epoch
D. Low-voltage mixed-frequency activity with sawtooth waves
CORRECT ANSWER: B. Sleep spindles and K-complexes
, EEG BOARD PREP ASAP T Study Guide PDF |
Complete Electroencephalography
Certification Exam Review | R. EEG T Board Prep,
EEG Waveforms, Seizure Patterns, Epileptiform
Discharges, Artifact Recognition, Activation
Procedures & Clinical Correlations Bundle
RATIONALE: Stage N2 sleep is defined by the presence of sleep spindles (11–16 Hz, typically 12–14 Hz)
and/or K-complexes (high-amplitude biphasic waves) on a background of theta activity. These features
distinguish N2 from N1 (vertex waves, theta) and N3 (delta waves ≥20% of epoch).
Question 10: What is the minimum duration of electrographic seizure activity required for diagnosis of
nonconvulsive status epilepticus according to ACNS critical care EEG terminology?
A. 10 seconds
B. 30 seconds
C. 5 minutes
D. 10 minutes
CORRECT ANSWER: D. 10 minutes
RATIONALE: ACNS standardized critical care EEG terminology defines nonconvulsive status epilepticus as
electrographic seizures lasting ≥10 minutes, or recurrent seizures without return to baseline between
events. This duration threshold helps distinguish true status from brief ictal events and guides urgent
treatment decisions.
Question 11: Which artifact is characterized by rhythmic, sinusoidal waveforms at approximately 1 Hz
that correlate with the patient's pulse?
A. Respiratory artifact
B. EKG artifact
C. Pulse artifact
D. Glossokinetic artifact
CORRECT ANSWER: C. Pulse artifact
RATIONALE: Pulse artifact appears as rhythmic, sinusoidal slow waves (~1 Hz) time-locked to the cardiac
cycle, often maximal over frontal or temporal regions where electrodes overlie arteries. It results from
mechanical pulsation of blood vessels beneath the electrode and can be confirmed by simultaneous EKG
or pulse oximetry.
Question 12: In pediatric EEG, what is the expected posterior dominant rhythm frequency for a
normal 5-year-old child?
A. 3–4 Hz
B. 5–6 Hz
C. 7–8 Hz
D. 9–10 Hz
