This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Surveys of primary care physicians indicate that seizures are 1 of the top 5 reasons to obtain an e-consult with a neurologist, with diagnostic tests such as EEG among the top reasons to request reevaluation,1 especially because EEG is an essential, well-established diagnostic tool for evaluating and managing people with epilepsy.2 Visual interpretation of EEG recordings has high specificity for an epilepsy diagnosis based on the presence of abnormal epileptiform discharges (EDs), but only moderate and variable interrater reliability3,4 for correct interpretation. Pitfalls for correct ED identification include overinterpretation of the EEG and can lead to misdiagnosis of people who do not have epilepsy.5 The initial criteria adopted by the International Federation of Clinical Neurophysiology (IFCN) to distinguish EDs are not sufficient to separate pathologic EDs from normal features of the EEG.6 Importantly, new definitions of epilepsy now include a single seizure, when it is associated with EDs. This underscores the critical importance of EEG following an initial seizure. In turn, correctly interpreted EEG results may prompt treatment with antiseizure medication that may limit seizure recurrence.7
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
See page 871
- © 2020 American Academy of Neurology
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
Letters: Rapid online correspondence
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
You May Also be Interested in
Topics Discussed
Alert Me
Recommended articles
Criteria for defining interictal epileptiform discharges in EEG
Electromagnetic source imaging in presurgical workup of patients with epilepsy
Electroencephalographic monitoring during hypothermia after pediatric cardiac arrest
Neuropsychiatric symptomatology predicts seizure recurrence in newly treated patients