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Updated: Sep 4, 2025

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EEG normal variants: A prospective study using the SCORE system.

Stephan Wüstenhagen1, Daniella Terney1, Elena Gardella1,2

  • 1Department of Clinical Neurophysiology, Danish Epilepsy Centre, Dianalund, Denmark.

Clinical Neurophysiology Practice
|July 22, 2022
PubMed
Summary

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This study identified common normal variants in electroencephalogram (EEG) recordings, emphasizing sharp transients. Familiarity with these EEG variants is crucial to prevent misdiagnosis in patients.

Area of Science:

  • Neuroscience
  • Clinical Electrophysiology

Background:

  • Electroencephalogram (EEG) recordings are essential for diagnosing neurological conditions.
  • Normal variants in EEG can be mistaken for abnormal findings, leading to misdiagnosis.

Purpose of the Study:

  • To determine the prevalence and characteristics of normal variants in a large EEG cohort.
  • To provide educational examples of normal EEG variants.

Main Methods:

  • Utilized the SCORE EEG system for prospective extraction of EEG features.
  • Analyzed 3050 EEG recordings from 2319 patients (age range 1-89 years).

Main Results:

  • Sharp transients were the most prevalent normal variant (19.21%), followed by rhythmic temporal theta of drowsiness (6.03%).
Keywords:
Benign epileptiform variantsEEGEpilepsyNormal variant

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  • Other identified variants included temporal slowing, slow fused transients, 14-and-6 Hz bursts, breach rhythm, small sharp spikes, 6-Hz spike and slow wave, and SREDA.
  • Prevalence rates for other variants ranged from 0.03% to 2.89%.

    • Conclusions:

    • Sharp transients are the most common normal variant and should not be misidentified as epileptiform discharges.
    • Healthcare professionals interpreting EEGs must be knowledgeable about normal variants to ensure accurate patient classification and diagnosis.