Methohexital as an activator in epileptic patients with normal electroencephalograms

The activation by a short-acting barbiturate, methohexital, of spike and wave discharges in epileptic patients with normal EEG tracings was evaluated. Seventy-five patients and 20 healthy control subjects were studied. Non-specific changes--desynchronization, fast sharp activity and diffuse slowing--appeared in all the tracings. Only eleven patients had positive activation after methohexital administration. The results were not encouraging and indicate that methohexital is not reliable as a diagnostic tool in problematic cases of verified or suspected epilepsy with normal EEG tracings.