There are many types of epilepsy in clinical practice, and the location and spread of abnormal brain discharges vary in different types of epilepsy, in addition, the EEG performance during seizures and during non-seizures may not be the same, so it seems that the EEG performance of children with epilepsy is also diverse, and not all children with epilepsy have abnormal EEG performance at all times, sometimes it may appear completely normal during recording, and some Some patients need to record the EEG several times, or extend the recording time, or add other means such as video recording, in order to catch abnormal EEG signals that can be helpful for diagnosis. In addition, many hospitals do not follow formal protocols for EEG examinations, and human factors can increase the number of “normal EEGs,” so experience is needed to see the images. In general, patients with rare seizures, complex partial seizures and other seizures originating from deeper parts of the brain are not easy to catch abnormal EEG, so the reason should be found and the EEG examination strategy should be adjusted to reduce the possibility of missing the diagnosis. In China, there are many types of EEG instruments used in clinical practice, so the common EEG examination options are awake EEG, sleep EEG, video EEG (video EEG), 24-hour dynamic EEG and polysomnography. Depending on the patient’s condition, different EEG methods can be chosen. 1.Wake EEG. That is, the patient is awake when the EEG is recorded. Nowadays, it is generally required to record more than half an hour in China. During the tracing process, the patient has to open and close the eyes, transition to change breath (big gasp) and other actions to cooperate. Sometimes, flash stimulation and pterygoid electrodes are added to improve the ability to catch abnormal brain waves. 2. Sleep EEG. The child is asleep when the tracing is done, but not after falling asleep. It is better to start from the awake state, sleepy, light sleep and deep sleep state. In general, abnormal EEG is most likely to appear during sleep, so sleep EEG is one of the best ways to detect abnormal brain waves. It is best to sleep without sleeping pills because if you fall asleep with sleeping pills, you will soon fall into deep sleep and thus miss the easiest time to detect abnormal EEG. Moreover, studies have shown that sleeping pills can interfere with EEG results and diminish the chance of abnormal EEG appearing during sleep. Therefore, we do not advocate having patients take sleeping pills for EEG, but rather natural sleep or sleep deprivation for EEG. For children who are too young and uncooperative, sedatives can be used, and chloral hydrate is recommended. Sleep deprivation is to keep the child awake for a period of time in the morning or at night, depending on the age of the child, so that the child can easily fall asleep when the test is done. Sleep EEG is easy to perform in pediatric patients, but not easily done in adults, who have difficulty falling asleep in unfamiliar environments. In addition to the difference in the positive rate of abnormal brain waves, the basal EEG traced is also different between awake EEG and sleep EEG. The awake EEG reflects the state of brain maturation and normal function, while the sleep EEG can reflect whether the sleep staging markers are normal or not, and thus presume whether the brain function is normal or not. Therefore, waking state EEG and sleeping state EEG are not interchangeable. In general, patients suspected of having epilepsy should theoretically have awake EEG and sleep EEG. 3. 24-hour EEG. The characteristics are that the recording time is longer and the 24-hour EEG can be recorded by walking freely with the recording box on the back. The disadvantage is that it is less resistant to interference, the patient’s activity cannot be videotaped, and the relationship between seizures and EEG is difficult to determine. The newer machines also utilize digital technology for more accurate and reliable positioning, and the EEG recording technique has been greatly improved. In general, patients with no epileptiform waves recorded in routine awake and sleep EEGs, and patients with high suspicion of epilepsy, as well as patients who have been on a full course of medication, no seizures, and are ready to finally discontinue medication should have a 24-hour dynamic EEG. 4. Video EEG (video EEG). The latest type of video EEG uses digital video equipment to record the patient’s onset and EEG is highly synchronized in time. The length of the recording time is determined by the patient’s condition and can be as short as half an hour or as long as several days, usually about half a day, including the awake part and the sleep part, that is, including the aforementioned awake EEG and sleep EEG, but not the sum of the two. The diagnosis of epilepsy relies primarily on the characteristic manifestations of seizures. Without the characteristic manifestations of epilepsy, epilepsy cannot be diagnosed, and typical seizure manifestations are important in confirming the diagnosis of epilepsy. Common manifestations include grand mal seizures, partial motor seizures and disoriented seizures. The person providing the history should preferably be a witness, because in most cases, the person who witnessed the onset of the seizure is not a medical professional or specialist, and the description is often not very accurate. In most cases, the doctor cannot witness the patient’s seizures, but now with the development of video EEG technology, more and more seizures can be recorded. The doctor can record the patient’s seizures in chronological order, how the seizures start, how each part of the body, from which parts the seizures start first, the duration of the seizures, whether the mental clarity and other abnormal changes in the EEG during the same period. It is very important to diagnose and identify patients with seizures and to help classify them as epilepsy. This device is highly resistant to interference and is particularly useful for pediatric patients with uncooperative, diverse and frequent seizures, and refractory epilepsy. Video EEG can significantly improve the rate of confirmatory diagnosis of epilepsy.