Electroencephalography

While EEG may be very helpful, it is not readily available in most emergency departments. Emergency EEG can be considered in the evaluation of a patient with persistent, unexplained, altered mental status to rule out nonconvulsive status epilepticus; to evaluate a paroxysmal attack when a seizure is suspected; or in status epilepticus to detect ongoing seizures after paralysis for intubation, or induction of general anesthesia. 7

In the outpatient setting, the EEG may be used to distinguish generalized from focal seizures and to identify specific epileptic syndromes. The diagnostic yield of EEG recordings can be increased by appropriate patient preparation (especially sleep deprivation) or by activation techniques such as hyperventilation, photic stimulation, and sleep recordings. More elaborate examinations, such as 24-h recordings or video-EEG recordings, may also be used. Consultation with a neurologist ensures that the appropriate studies are chosen.

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