Background: Epilepsy is a neurological syndrome with a significant associated morbidity and mortality. An electroencephalogram (EEG) is an important tool to assist in the diagnosis of epilepsy. Sleep deprivation is a well-known risk factor for seizures and forms a basis for why sleep-deprived EEGs may assist in diagnosing epilepsy. There is mixed evidence regarding the utility of sleep deprivation in identifying signs of seizure activity, known as epileptiform activity. This study aimed to assess whether sleep-deprived EEGs increase the yield of epileptiform activity, compared with routine EEGs.

Methods: This was a retrospective observational study (January, 2018 to January, 2023) in patients of all ages who underwent routine and sleep-deprived EEGs at a major tertiary referral centre. Descriptive statistical analysis was undertaken in addition to the Fisher exact test and McNemar test to facilitate comparison of matched pairs.

Results: There were 116 patients included in the study. The median age at time of first EEG was 32.5 years (interquartile range (IQR) 18-53). Fifty four percent of patients were male and 80% of patients were aged ≥18 years. The diagnostic yield of epileptiform activity was 21% when the results of both the routine and sleep-deprived EEG studies were included. There was no significant difference in the yield of epileptiform activity in routine versus sleep-deprived EEGs (12% versus 13% respectively, p = 1.0). Nine patients had epileptiform activity present on routine but not sleep-deprived EEG, and the reverse was true for 10 patients. There were several study limitations, including the varied time interval between EEG studies and limited referral documentation.

Conclusions: The study findings suggest that, in the correct clinical context, undertaking both a routine and sleep-deprived EEG, regardless of the order, may have benefit in identifying epileptiform activity. These findings also reinforce important data points that should be included with EEG referrals, to help optimise future research in this area.

Keywords: electroencephalography; epilepsy; seizures; sleep-deprivation.

© 2025 The Author(s). Published by IMR Press.

背景： 癫痫是一种具有显著相关发病率和死亡率的神经系统综合征。脑电图（EEG）是辅助诊断癫痫的重要工具。睡眠剥夺是一个众所周知的引发癫痫发作的风险因素，这也是为什么睡眠剥夺EEG可能有助于诊断癫痫的基础。关于睡眠剥夺在识别癫痫样活动中的作用存在混合证据。本研究旨在评估与常规EEG相比，睡眠剥夺EEG是否能增加癫痫样活动的检出率。

方法： 这是一项回顾性观察性研究（2018年1月至2023年1月），纳入了所有年龄段在一家大型三级转诊中心接受常规和睡眠剥夺EEG检查的患者。除了描述性统计分析，还进行了Fisher确切检验和McNemar配对比较测试。

结果： 本研究共纳入了116名患者。首次EEG时的中位年龄为32.5岁（四分位距IQR 18-53）。患者中有54%是男性，80%的患者年龄≥18岁。当包括常规和睡眠剥夺EEG的结果时，癫痫样活动的检出率为21%。在常规与睡眠剥夺EEG中，癫痫样活动的检出率无显著差异（分别为12%和13%，p = 1.0）。有9名患者仅在常规EEG中出现癫痫样活动，而在睡眠剥夺EEG中没有；反之亦然的情况则出现在10名患者身上。本研究存在一些局限性，包括两次EEG检查之间的时间间隔不一以及转诊记录有限。

结论： 研究结果表明，在正确的临床背景下，无论是在何时进行常规和睡眠剥夺EEG检查，都可能有助于识别癫痫样活动。这些发现也强调了在EEG转诊中应包括的重要数据点，以优化未来在此领域的研究。

关键词： 脑电图；癫痫；癫痫发作；睡眠剥夺。

© 2025 The Author(s). Published by IMR Press.