New Epilepsy Tech Could Cut Misdiagnoses by Nearly 70% Using Routine EEGs

Using a new tool that turns routine electroencephalogram (EEG) tests that appear normal into highly accurate epilepsy predictors, researchers may have uncovered a way for doctors to reduce epilepsy misdiagnosis.

To improve the ability of EEGs to diagnose patients suspected of having epilepsy, researchers studied what happens in the brains of patients when they are not experiencing seizures. Their tool, called EpiScalp, uses algorithms trained on dynamic network models to map brainwave patterns and identify hidden signs of epilepsy from a single routine EEG.

The new study analyzed 119 epilepsy patients from five major medical centers and 99 patients without epilepsy. When researchers reanalyzed the initial EEGs using EpiScalp, the tool correctly identified about 84% of true epilepsy cases and correctly ruled out 96% of non-epilepsy cases.

“This is where our tool makes a difference because it can help us uncover markers of epilepsy in EEGs that appear uninformative, reducing the risk of patients being misdiagnosed and treated for a condition they don’t have,” said Khalil Husari, co-senior author and assistant professor of neurology at Johns Hopkins. “These patients experienced side effects of the anti-seizure medication without any benefit because they didn’t have epilepsy. Without the correct diagnosis, we can’t find out what’s actually causing their symptoms.”

In certain cases, misdiagnosis happens due to misinterpretation of EEGs, Husari explained, as doctors may overdiagnose epilepsy to prevent the dangers of a second seizure. But in some cases, patients experience nonepileptic seizures, which mimic epilepsy. These conditions can often be treated with therapies that do not involve epilepsy medication.

“Even when EEGs appear completely normal, our tool provides insights that make them actionable,” said Sridevi V. Sarma, a Johns Hopkins biomedical engineering professor who led the work. “We can get to the right diagnosis faster because patients often need multiple EEGs before abnormalities are detected, even if they have epilepsy. Accurate early diagnosis means a quicker path to effective treatment.”

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