. Author manuscript; available in PMC: 2024 Mar 1.

Published in final edited form as: Epilepsia. 2023 Feb 10;64(3):602–618. doi: 10.1111/epi.17448

Table 5.

Proposed protocol for testing patients during seizures in routine and sleep electroencephalography (EEG)

Children < 6 years old	Children ≥ 6 years old and adults
Say the patient’s first name “Are you ok? “Lift both arms up/like Superman or touch toy with right & left hand/clap.” First say only, if not reacting show Postictally ask: “Did you know what just happened?”	Say the patient’s first name If reacting, ask: “What do you feel?” If not, touch arm “Lift arms.” First say only, if not reacting show “Please repeat and remember the following words: horse, table (for example) Postictally ask: “Did you have a seizure?” “Can you describe what happened?” “What did you feel right before/at the beginning of the event?” “Can you recall the words I said to you/what I asked to do?”
For testing of a potential absence seizure during generalized spike-and-wave discharge longer than 3–4 seconds, we suggest giving commands or words when the generalized discharge starts and continues during the length of absence. Patients are monitored for a spontaneous response and after the offset of discharge, asked what they were told.

Children < 6 years old

Children ≥ 6 years old and adults

Say the patient’s first name
“Are you ok?
“Lift both arms up/like Superman or touch toy with right & left hand/clap.”
- First say only, if not reacting show
Postictally ask:

“Did you know what just happened?”

Say the patient’s first name
- If reacting, ask: “What do you feel?”
- If not, touch arm
“Lift arms.”
- First say only, if not reacting show
“Please repeat and remember the following words: horse, table (for example)
Postictally ask:

“Did you have a seizure?”
“Can you describe what happened?”
“What did you feel right before/at the beginning of the event?”
“Can you recall the words I said to you/what I asked to do?”

For testing of a potential absence seizure during generalized spike-and-wave discharge longer than 3–4 seconds, we suggest giving commands or words when the generalized discharge starts and continues during the length of absence. Patients are monitored for a spontaneous response and after the offset of discharge, asked what they were told.

Modified from Beniczky S, Neufeld M, Diehl B, Dobesberger J, Trinka E, Mameniskiene R, et al. Epilepsia. 2016; 57(9), Wiley Periodicals, Inc. and Pressler R, Seri S, Kane N, Martland T, Goyal S, Iyer A, et al. Seizure. 2017; 50, Elsevier.