What are the key indications for requesting an EEG in a primary care setting?

Key indications for requesting an electroencephalogram (EEG) in a primary care setting include:

• If the person's history and examination suggest an epileptic seizure and a diagnosis of epilepsy is suspected, consider a routine EEG carried out while awake to support diagnosis and provide information about seizure type or epilepsy syndrome.
• Perform an EEG as soon as possible (ideally within 72 hours) after a first suspected seizure if requested.
• Use EEG to support diagnosis but not to exclude epilepsy, as a normal EEG does not rule out epilepsy.
• When offering EEG, discuss the benefits and risks of provoking manoeuvres (such as hyperventilation and photic stimulation) with the person and their family or carers, and include these if agreed.

These indications are primarily to aid diagnosis after a first suspected seizure or when epilepsy is suspected based on clinical assessment in primary care.

Note: EEG is not routinely used to exclude epilepsy and should be part of a broader clinical assessment including history, examination, and possibly neuroimaging or ECG as indicated.

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