Subtle signs of epilepsy on ‘normal’ scalp electroencephalography


  • The diagnostic yield of routine scalp electroencephalography (EEG) could potentially be improved in people with epilepsy. Alpha spectral changes were able to distinguish people with drug-resistant focal epilepsy (DRFE) and normal EEG from healthy individuals (area under the curve [AUC], 0.83).

Why this matters

  • Routine scalp EEG of 20 to 60 minutes is a cornerstone of epilepsy diagnosis; however, many people with epilepsy record normal scalp EEGs with no epileptiform activity, recorded seizures, or other abnormalities, resulting in delayed diagnosis and treatment.

  • It is possible that short and apparently normal scalp EEGs could still contain subtle electrophysiological changes, revealing a possible epilepsy diagnosis despite a lack of typical epileptiform activity.