The electroencephalogram as a screening tool in pilot applicants

Area of Science:

• Aviation Medicine
• Neurology
• Aerospace Physiology

Background:

• Electroencephalogram (EEG) is utilized in many European countries to screen pilot candidates for licensure, excluding those with paroxysmal abnormalities.
• The primary objective of this screening is to mitigate the risk of in-flight seizures, which could lead to accidents or fatalities.

Purpose of the Study:

• To evaluate the efficacy of EEG screening in reducing the risk of seizures among pilot candidates.
• To determine if current EEG screening protocols offer significant risk reduction for commercial aviation safety.

Main Methods:

• Review of existing evidence on the predictive value of EEG in identifying individuals at risk for seizures.
• Analysis of seizure incidence in healthy young adults and the associated risk of commercial aircraft accidents.
• Consideration of the limitations of EEG in predicting later-onset seizures unrelated to initial screening results.

Main Results:

• There is a lack of clear evidence demonstrating significant risk reduction from EEG screening in pilot populations.
• The effectiveness of EEG screening is limited by its low predictive value and the low inherent risk of seizures in healthy young adults.
• Screening cannot predict or prevent later-onset seizures that are unrelated to initial EEG findings.

Conclusions:

• The current practice of broad EEG screening for pilot candidates may not substantially enhance aviation safety.
• While some benefit cannot be entirely ruled out, demonstrating it prospectively is challenging.
• Targeted screening, such as for photosensitivity in helicopter pilot candidates, may be justifiable, requiring further prospective studies with standardized protocols.