Abstract
Background/Objectives Epilepsy is a neurological syndrome with a significant associated morbidity and mortality. An electroencephalogram (EEG) is an important tool to assist in making the diagnosis of epilepsy. Sleep deprivation is a well-known risk factor for seizures and forms a basis for why sleep-deprived EEGs may assist in diagnosing epilepsy. There is mixed evidence as to the utility of sleep deprivation in identifying signs of seizure activity, known as epileptiform activity. This study aimed to assess whether sleep-deprived EEGs increased the yield of epileptiform activity, compared to routine EEGs.
Methods Retrospective observational study undertaken over a five-year period in patients of all ages at a major tertiary referral centre.
Results There were 116 patients included in the study. The average age at the time of EEG acquisition was 37.8 years (IQR 35). 54% of patients were male and 20% of patients were under 18 years of age. There was no significant difference in the identification of epileptiform activity in routine versus sleep-deprived EEGs (12% versus 13%, respectively). Some patients had epileptiform activity present on routine but not sleep-deprived EEG, and vice versa. There were several study limitations, most prominently the varied time interval between EEG studies.
Conclusions The study findings suggest that, in the right clinical context, undertaking both a routine and sleep-deprived EEG, regardless of the order, may have benefit in identifying epileptiform activity. These findings also reinforce important data points that should be included with EEG referrals to help optimise future research into this area.
