# EpiScalp: An EEG Analytics Solution to Improve Diagnosis of Epilepsy

> **NIH NIH R44** · NEUROLOGIC SOLUTIONS, INC. · 2024 · $1,204,564

## Abstract

Project Summary
 According to the WHO, an estimated 5 million people worldwide receive a diagnosis of epilepsy annually.
Unfortunately, misdiagnosis rates range between 20% to 42%. A false positive leads to inappropriate
treatment with unnecessary antiseizure medication with potential adverse reactions, failure to receive suitable
therapy for the correct diagnosis, and unnecessary restrictions that arise with the stigma of epilepsy. A false
negative comes with increased risks of seizure recurrence, status epilepticus, and premature death. The
diagnosis of epilepsy depends on a comprehensive clinical history, neurological examination, and ancillary
studies including scalp electroencephalography (EEG). Scalp EEG can confirm an epilepsy diagnosis if
abnormalities indicating epilepsy, such as random interictal (between seizure) epileptiform discharges (IEDs) or
focal slow wave activity, are present and detected by visual inspection. However, the sensitivity of abnormalities
being present in the EEG varies from 29-55%, and the ability for clinicians or EEG technicians to detect them by
visual inspection varies. EEG artifacts can both mask IEDs and be mistaken for IEDs. Consequently, it takes
multiple visits, months, or even years to be accurately diagnosed.
 We propose to further develop and validate EpiScalp, a revolutionary EEG analytics algorithm to enhance
diagnostic accuracy. EpiScalp produces a risk score between 0-1 from 10-20 minutes of EEG data and does
not rely on the presence of EEG abnormalities. Instead, our novel algorithm predicts epilepsy in resting-state (no
seizure) brain networks using a dynamic network model. In Phase 1, EpiScalp underwent evaluation on 198
patients with EEGs void of abnormalities during their first visits. An alarming 54% (107) of these patients were
misdiagnosed as having epilepsy when they did not. EpiScalp achieved definitive diagnoses for 168 of 198
patients with low (epilepsy unlikely) and very (epilepsy likely) risk scores, demonstrating remarkable accuracy,
sensitivity, and specificity at 93%, 92%, and 95% respectively. EpiScalp could have reduced misdiagnoses from
54% to 17% (a 69% reduction).
 EpiScalp's predictive capabilities extend to patients undergoing long-term EEG monitoring within the
epilepsy monitoring unit (EMU). Notably, 30-50% of EMU beds are occupied by non-epileptic patients, resulting
in care delays for those requiring admission due to seizure exacerbation or medically refractory epilepsy needing
surgical evaluation. This issue significantly impacts center efficiency and care quality. Through risk-based patient
triage, EpiScalp improves care quality for epilepsy patients in need and empowers centers to efficiently assess
more potential surgical candidates. This optimization of EMU resources enables timelier treatment for patients.
In Phase 2, we aim to validate EpiScalp through prospective observational studies involving first visit and EMU
patients at 3 renowned epilepsy centers in the US...

## Key facts

- **NIH application ID:** 10918584
- **Project number:** 1R44NS137845-01
- **Recipient organization:** NEUROLOGIC SOLUTIONS, INC.
- **Principal Investigator:** Andrew Gotshalk
- **Activity code:** R44 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $1,204,564
- **Award type:** 1
- **Project period:** 2024-08-13 → 2027-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10918584

## Citation

> US National Institutes of Health, RePORTER application 10918584, EpiScalp: An EEG Analytics Solution to Improve Diagnosis of Epilepsy (1R44NS137845-01). Retrieved via AI Analytics 2026-06-12 from https://api.ai-analytics.org/grant/nih/10918584. Licensed CC0.

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