Background EEG is a useful tool if requests are appropriate and results correctly interpreted.
Investigations We conducted a survey among NCHDs. Three questions were asked. The first established ability to distinguish syncope from seizure based on history. The second evaluated understanding of reports and if they ruled out a seizure. Question three asked if an EEG is part of the ‘collapse’ work-up.
Results 119 responses out of 179 questionnaires: Incorrect responses from 86 Interns, 20 SHOs and 13 Registrars respectively: (1). 50%, 20%, 38%, (2). 4.6%, 10%, 0%, (3). 8.1%, 0%, 0%.
Discussion Collapse is a common presentation to the Emergency department. Diagnosis rests largely with clinical history, but eye-witnesses often describe jerking of limbs with syncope. This is often attributed to epilepsy and our results highlight this. Performing an EEG in a likely syncope may result in over-interpretation of changes and may have cost implications. Additionally, EEG can be useful in suspected epilepsy, but a proportion of individuals with epilepsy may never have an ‘epileptiform’ EEG and correct interpretation of reports is vital. General physicians continue to believe that EEG can diagnose epilepsy. We present these findings and discuss potential ways to reduce EEG misuse.
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