Detecting interictal discharges in first seizure patients: ambulatory EEG or EEG after sleep deprivation?


A first seizure has a significant psychological impact on patients [1] where the clinician’s role includes finding a potential cause and estimating the recurrence risk. Main predictors for recurrence are symptomatic etiology and the presence of interictal epileptiform discharges (IEDs) on the EEG. While highly specific, the sensitivity of a routine EEG after a first unprovoked seizure is limited, ranging from 25 to 50% [2]. Longer registrations or recordings during sleep increases the yield to 50–75% [3,4].


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