Following a recommendation from a Good Practice Guide published in Scotland stating that EEG should not be routinely used in the diagnosis of epilepsy in the elderly, we conducted a retrospective study to ascertain the effects this recommendation had. We found that predating the recommendation, there had already been a decline in the use of EEG in people aged 65 and over. Detailed examination of a 3.5-year epoch which straddled 2 years before the recommendation and 1.5 years after its publication revealed no evidence of a change in the type of referrals but just in the number of referrals. Comparison with 2 younger cohorts showed that EEG in the elderly had the same specificity and sensitivity as in the younger age groups and was of particular use in picking up previously unsuspected non-convulsive status. We conclude the EEG remains an important diagnostic adjunct in the elderly.
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