Electroencephalographic assessment of patients with epileptic seizures

Abstract

This article reviews the role of EEG in the diagnosis and management of patients with epilepsies. We review the morphologic and behavioral characteristics of the interictal and ictal EEG markers of the different types of epilepsy that should guide recording strategies to augment its diagnostic yield, and we attempt to delineate those particular features that may be relevant to the main epilepsy syndromes. Particular emphasis is placed on the activation methods, including hyperventilation, sleep deprivation and sleep, and specific triggers, as well as how these may differ between idiopathic and cryptogenic/symptomatic generalized and focal epilepsies, commenting on possible diagnostic pitfalls and areas of uncertainty. We also consider the indications for long-term recordings (video – telemetry and ambulatory) and emphasize the diagnostic value of polygraphic recordings.

Keywords::

• epilepsy surgery
• epilepsy syndrome classification
• epilepsy syndromes
• focal spikes
• generalized spike wave discharges
• polygraphy
• sleep deprivation
• sleep EEG
• video EEG
• video telemetry

Acknowledgement

We would like to express our gratitude for the generous moral support and the charitable donation kindly bestowed to us by Mrs Ellis Stewart in honor of the memory of her belated son Gordon Stewart; her support encourages us to continue our research on epilepsies.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.