title: Yield of epileptiform electroencephalogram abnormalities in incident unprovoked seizures: a population-based study.
abstract: OBJECTIVE
  The yield of epileptiform abnormalities in serial electroencephalography (EEG) studies has not been addressed in a population-based setting for subjects with incident epilepsy or a single unprovoked seizure, raising the possibility of methodologic limitations such as selection bias. Our aim was to address these limitations by assessing the yield and predictors of epileptiform abnormalities for the first and subsequent EEG recording in a study of incident epilepsy or single unprovoked seizure in Rochester, Minnesota.
  
  
  METHODS
  We used the resources of the Rochester Epidemiology Project to identify all 619 residents of Rochester, Minnesota, born in 1920 or later with a diagnosis of incident epilepsy (n = 478) or single unprovoked seizure (n = 141) between 1960 and 1994, who had at least one EEG study. Information on all EEG studies and their results was obtained by comprehensive review of medical records.
  
  
  RESULTS
  Among subjects with epilepsy, the cumulative yield of epileptiform abnormalities was 53% after the first EEG study and 72% after the third. Among subjects with a single unprovoked seizure, the cumulative yield was 39% after the first EEG study and 68% after the third. Young age at diagnosis and idiopathic etiology were risk factors for finding epileptiform abnormalities across all EEG recordings.
  
  
  CONCLUSIONS
  Although the cumulative yield of epileptiform abnormalities increases over successive EEG recordings, there is a decrease in the increment for each additional EEG study after the first EEG study. This is most evident in incident epilepsy and in younger subjects. Clinically it may be worthwhile to consider that the probability of finding an epileptiform abnormality after the third nonepileptiform EEG recording is low.
authors.affiliation: Gertrude H. Sergievsky Center, Columbia University, New York, New York, U.S.A.
authors.forename: Elisa
authors.initials: E
authors.lastname: Baldin
authors.forename: W Allen
authors.initials: WA
authors.lastname: Hauser
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Buchhalter
authors.forename: Dale C
authors.initials: DC
authors.lastname: Hesdorffer
authors.forename: Ruth
authors.initials: R
authors.lastname: Ottman
mesh_terms: D000293:Adolescent; D000328:Adult; D058256:Brain Waves / Q000502:physiology*; D002648:Child; D018672:Community Health Planning; D004569:Electroencephalography; D004827:Epilepsy / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D055815:Young Adult
keywords: Electroencephalography; Epidemiology; Epilepsy; Epileptiform abnormality; Population-based