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.