Does hyperventilation increase the diagnostic sensitivity of routine electroencephalography in adults with suspected epilepsy?

Objective: We aimed to explore the role of hyperventilation (HV) during routine EEG recordings in the diagnosis of adults with epilepsy. Methods: During the COVID-19 pandemic we removed HV from routine EEG recordings due to the transmission risks. Routine EEGs conducted in the year before and after the COVID-19 pandemic were re-evaluated. Results: A total of 167 HV + and 199 HV - EEGs were analyzed. To ensure comparability between the two groups with respect to age and conditions that could contraindicate HV, patients >= 55 years and with any conditions contraindicating HV were excluded from both groups. In patients with a diagnosis of epilepsy the prevalence of epileptiform abnormalities was 26.7 % in the HV + and 24.5 % in the HV - group (p = 0.727). Conclusions: This study did not reveal any evidence indicating that HV improves the diagnostic sensitivity of routine EEG in adults with epilepsy. In adults, hyperventilation during routine EEG recordings may be most useful in incre in patients with a history of absence seizures or seizures triggered by hyperventilation.