The Under-utilization of the EEG: a study

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by Jay Gunkelman - April 11, 2013

The Mayo Clinic researchers looked at the EEG utilization clinically, and found that it was being seriously under-utilized.  They suggest lowering the threshold for ordering the EEG in cases with alterations of consciousness, lapses in awareneess and cognitive decline.  The finding or non-convulsive paroxysms is still treatable with an empirical trial on anticonvulsants when there are paroxysms in these cases.

The presence of paroxysms also changes medication choices in psychiatry, with Lithium and antipsychotic medications which lower the threshold for discharges becoming a poor choice, and the use of anticonvulsants being strongly suggested. 

The raw EEG is better at diagnostically identifying these epileptiform discharges than the quantitative processing, though the quantitative analysis oriented to dipole analysis is strongly supported by the most conservative groups's position papers, like the AAN and IFCN.

The link below goes to a source for this paper.




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