EEG in suspected syncope: do EEGs ordered by neurologists give a higher yield?

Area of Science:

• Neurology
• Diagnostic Yield
• Patient Management

Background:

• Prior studies indicate low diagnostic yield for electroencephalograms (EEGs) in syncope evaluation.
• The impact of referring physician specialty on EEG yield for syncope remains understudied.

Purpose of the Study:

• Determine if neurologists ordering EEGs for syncope yield higher diagnostic results.
• Assess if abnormal EEG findings significantly alter patient management.

Main Methods:

• Retrospective review of EEG records for syncope, loss of consciousness, or falls (2003-2007).
• Analysis of medical records for patients with abnormal EEG findings.

Main Results:

• Only 11.0% of 517 EEGs were abnormal; 1.6% showed potentially epileptic activity.
• No significant difference in EEG yield between neurologists and non-neurologists.
• Abnormal EEGs led to further investigations in 5 cases; one patient received phenytoin.

Conclusions:

• EEGs for suspected syncope have extremely low diagnostic utility.
• EEG findings rarely alter patient management, irrespective of the referring physician's specialty.