Overintepretation of EEGs and misdiagnosis of epilepsy

The overinterpretation of EEGs is a known problem that has not been reported specifically. The authors report a series of EEGs on patients who were diagnosed eventually with psychogenic nonepileptic seizures and who had an EEG read as epileptiform. Of the 15 actual records available for review, the overread patterns were wicket spikes (n = 1), hypnagogic hypersynchrony (n = 1), and hyperventilation-induced slowing (n = 1). In the other 12 records, the overread patterns were simple fluctuations of sharply contoured background rhythms or fragmented alpha activity. Rather than well-described normal variants, the overinterpreted patterns tend to be normal fluctuations of background activity.