Multiple Choice Question on Epilepsy Surgery (Correct Answer is in Bold and Underlined)

• Q.1 If the patient has failed 2 drugs in their appropriate combination and dosage, the likely chance of the third drug to control epilepsy would be

  • A) <5%

  • B) 10–20%

  • C) 20–30%

  • D) 40–50%

• Q.2 Which of the following facts about drug resistant epilepsy (DRE) in NOT true?

  • A) DRE occurs as a result of long standing acquired drug resistance

  • B) DRE is do novo and can be identified early in the course of disease

  • C) DRE may be suspected when the response to first drug fails

  • D) The only viable option for DRE is epilepsy surgery

• Q.3 Which of the following is NOT true about epilepsy surgery?

  • A) This is a surgery performed primarily for curing/controlling drug resistant epilepsy

  • B) MRI has to show a lesion for the surgery to be successful

  • C) Multi-modal imaging clearly identifies the epileptogenic networks

  • D) The 10 year seizure free outcome for mesial temporal sclerosis ranges from 50–60%

• Q.4 Which of the following is NOT a curative surgery?

  • A) Hemispherotomy

  • B) Multiple sub-pial transection

  • C) TPO disconnection

  • D) Lesionectomy

• Q.5 Which of the following is NOT true about hippocampal sclerosis surgery?

  • A) Recent meta-analysis has shown better outcome for a standard temporal lobectomy combined with amygdalo-hippocampectomy when compared to selective amygdalo-hippocampectomy

  • B) Hippocampus has to be resected upto the level of superior colliculus to ensure better outcomes

  • C) Both dorsal and ventral amygdala has to be excised to ensure a seizure free outcome

  • D) The adjacent structures like entero-rhinal cortex, uncus, para-hippocampal cortex also has to be excised

• Q.6 Which of the facts in NOT true about hemispherotomy?

  • A) Functional hemispherotomy was first described by Rasmussen

  • B) There are basically 2 techniques for hemispherotomy- per-insular and vertical trans-cortical

  • C) Hemispherotomy provides one the best outcomes in epilepsy surgery

  • D) The chief reason that the anatomical hemispherectomy was given up was due to post operative hydrocephalus

• Q.7 Which of the following is the most relevant indication for corpus callosotomy?

  • A) Lenox-Gestaut with drop attacks

  • B) DRE without any localization

  • C) Infantile spasms

  • D) Myoclonic jerks

• Q.8 Which of the following is NOT true about surgical aspect of focal cortical dysplasia?

  • A) Electro corticography is useful for localization and resection

  • B) Trans mantle sign is found in Type I Palmini

  • C) FCD may be associated with certain tumors

  • D) Hemi-megelencephaly is a very severe form of FCD

• Q.9 Which of the following is NOT true about vagal nerve stimulation?

  • A) VNS should be treated like another drug

  • B) VNS leads to about 50% seizure free outcome in about 50% of cases

  • C) VNS has similar indications as for copuscallosotomy

  • D) VNS may be also indicated in certain lesional cases

• Q.10 Which of the following is NOT true about SEEG?

  • A) It may be performed using both a robotic device and standard stereotactic frame even the former is more convenient

  • B) Has lesser morbidity than standard depth electrodes

  • C) Is performed using a burrhole

  • D) Since it is fitted using an anchor bolt, may be explanted easily

No conflict of interest has been declared by the author(s).