Reporting EEG

Question 1

What are the main headings you need to consider when reporting an EEG?

Answer 1

Patient information
Technical details
Background activity
Abnormal findings
Normal variants
Clinical correlation and impression

Question 2

1. Patient information and indication?

Answer 2

Name
Age
Sex
Clinical Hx
Reason for EEG (sz’s, developmental delay, altered consciousness)

Question 3

2. Technical details?

Answer 3

Date and duration of EEG

Wakefulness/sleep states recorded

Medications (especially sedatives/antiepileptics)

Recording technique:

• Number and type of electrodes (usually 10–20 system)
• Any additional electrodes (e.g. sphenoidal, ECG, EMG)
• Video monitoring used?
• Hyperventilation, photic stimulation, sleep deprivation?

Question 4

3. Background Activity?

Answer 4

Frequency and symmetry

Organization relative to age (e.g. expected alpha rhythm in older children, delta/theta in infants)

Reactivity to eye opening/closing

Sleep features if recorded (e.g. vertex waves, K-complexes, sleep spindles)

Question 5

4. Abnormal Findings?

Answer 5

Slowing: Focal vs. generalized; continuous or intermittent

Epileptiform activity: Spikes, sharp waves, spike-and-wave discharges

Location (e.g. centrotemporal, occipital)

Frequency

Activation by sleep or stimulation

Seizures (if any): Description of clinical and EEG features

Question 6

5. Normal Variants?

Answer 6

Benign epileptiform transients of sleep (BETS)

Lambda waves, mu rhythm, etc., if relevant

Question 7

6. Clinical Correlation and Impression?

Answer 7

Summary of findings (normal vs. abnormal)

Possible syndromic patterns (e.g. benign Rolandic epilepsy, West syndrome, Lennox-Gastaut)

Correlation with clinical presentation

Recommendation for further evaluation or management if needed

Question 8

Can you give a brief example of real world example of reporting an EEG?

Answer 8

Patient: 6-year-old boy
Indication: Episodes of staring and unresponsiveness
Technique: Routine 30-minute EEG with video, awake and drowsy states, photic stimulation performed.
Background: Normal 8-9 Hz posterior dominant rhythm. Well-organized and reactive.
Findings: Intermittent spike-and-wave discharges over the centrotemporal regions, activated by drowsiness.
Impression: Abnormal EEG consistent with a benign focal epilepsy of childhood (Rolandic epilepsy). Clinical correlation recommended.