CLTM Exam Guide 2026: ABRET Long-Term Monitoring Prep
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Which of the following is the PRIMARY indication for long-term EEG monitoring in an epilepsy monitoring unit (EMU)?
Pre Study Preparation
Question · Easy
A practical 2026 CLTM exam guide for EEG technologists: ABRET eligibility, case-log rules, four-hour format, 5-domain outline, LTM safety, seizure capture, and free practice.
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When preparing a patient for EMU admission, which medication change is MOST commonly implemented to increase seizure capture?
Chapter 1: Pre-Study Preparation & Clinical Indications
1.1 Clinical Indications for Long-Term Monitoring
Study guide
According to the ILAE 2017 classification, a seizure that begins in one hemisphere with preserved awareness is classified as which type?
Question · Medium
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Which of the following patient populations requires special consideration for electrode selection and recording parameters in LTM?
Which comorbidity is MOST important to document before initiating long-term EEG monitoring because it can produce EEG patterns that mimic epileptiform activity?
The ACNS guidelines for critical care EEG terminology standardize which of the following terms for periodic sharp waves occurring over one hemisphere?
1.2 Patient History, Clinical Assessment & Neurological Evaluation
Prior to initiating ambulatory EEG monitoring, which communication point is MOST critical to convey to the patient?
Which procedure is used to determine language and memory lateralization as part of the presurgical epilepsy evaluation?
Which antiseizure medication is known to cause a characteristic EEG pattern of increased beta activity?
A patient with a known history of temporal lobe epilepsy is admitted for EMU monitoring. According to ACNS guidelines, what is the recommended minimum number of scalp electrodes for standard long-term monitoring?
1.3 Recording Strategy, Protocol Planning & Patient Communication
In the International 10-20 electrode placement system, what do the percentages 10 and 20 refer to?
Performing The Study
What is the recommended maximum electrode impedance for scalp EEG electrodes during long-term monitoring?
Which montage type displays each electrode referenced to a common electrode, such as Cz or the average of all electrodes?
During continuous EEG monitoring in the ICU, a burst-suppression pattern is observed. Which clinical condition is this pattern MOST commonly associated with?
Chapter 2: Electrodes, Montages & Technical Setup
2.1 Electrode Selection, Application & Scalp Integrity
Which EEG waveform is characterized by a sharp transient followed by a slow wave, lasting 70-200 milliseconds, and is considered an interictal epileptiform discharge?
What is the standard low-frequency filter (high-pass filter) setting for routine EEG recording?
During long-term monitoring, a technologist observes rhythmic 3 Hz generalized spike-and-wave discharges on the EEG while the patient stares blankly and is unresponsive. This pattern is MOST consistent with which seizure type?
Which type of EEG artifact is characterized by a regular, rhythmic deflection at approximately 1 Hz that correlates with the patient's pulse and is most prominent in electrodes near blood vessels?
2.2 True and Modified Montages for LTM
A CLTM technologist notices a high-amplitude, sharply contoured artifact in the frontal electrodes that occurs with each eye blink. What is the source of this artifact?
What is the MOST appropriate initial action when 60 Hz artifact is observed on multiple EEG channels during long-term monitoring?
During long-term monitoring, a patient's EEG shows a sudden onset of rhythmic theta activity at 5-7 Hz in the left temporal region that evolves in frequency and spatial distribution over 30 seconds. This pattern is MOST consistent with which finding?
Question · Hard
Which intracranial electrode type involves placing electrodes through burr holes into deep brain structures such as the hippocampus or amygdala?
2.3 Instrument Settings, Calibration & Differential Amplification
During stereo-EEG (sEEG) monitoring, a patient develops a sudden neurological deficit. What is the MOST concerning complication that requires immediate evaluation?
In continuous EEG monitoring for ICU patients, what does the term 'SIRPIDs' refer to?
Which EEG pattern in a critically ill patient is defined as continuous seizure activity lasting 5 minutes or more, or recurrent seizures without return to baseline between events?
What is the primary purpose of using a bipolar longitudinal (double banana) montage during EEG interpretation?
2.4 Signal Integrity, Impedance Monitoring & Artifact Troubleshooting
During ICU continuous EEG monitoring, the technologist identifies generalized periodic discharges (GPDs) at 1-2 Hz. Which clinical condition is MOST commonly associated with this pattern?
What is the recommended minimum sampling rate for digital EEG acquisition in long-term monitoring?
When performing cortical stimulation mapping through subdural grid electrodes, what is the PRIMARY goal of the procedure?
Which artifact appears as high-frequency, irregular spiky activity typically affecting temporal electrodes and is caused by contraction of the temporalis muscle?
Chapter 3: Seizure Classification, Semiology & Clinical Events
3.1 ILAE 2017 Seizure Classification Framework
A patient undergoing EMU monitoring has a focal onset impaired awareness seizure. The EEG shows rhythmic 5 Hz activity starting in the right temporal region, followed by postictal slowing in the same region. Which observation should the technologist document FIRST?
What is the significance of afterdischarges during cortical stimulation mapping?
In the 10-20 system, electrode T3 (or T7 in the modified 10-10 nomenclature) is located over which brain region?
Which quantitative EEG (qEEG) trending tool displays the compressed spectral power across frequencies over time and is commonly used during ICU continuous EEG monitoring?
3.2 Seizure Semiology & Ictal Phenotypes
During ambulatory EEG monitoring, the technologist discovers data loss for a 2-hour period mid-recording. What is the MOST likely cause?
What type of seizure is characterized by sudden bilateral, brief, involuntary muscle jerks that correspond to generalized polyspike-and-wave discharges on EEG?
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