The therapeutic dilemma: treating subtle seizures or indulging in electroencephalogram cosmetics?

The treatment of epileptiform abnormalities in the absence of obvious seizures has, in the past, been dismissed as "EEG cosmetics." The work on transitory cognitive impairment has highlighted the importance of asking the question: "What is a seizure?" The extent to which epileptiform discharges cause temporary or permanent impairment, profoundly influences decisions on whether to treat with antiepileptic medication or surgery.