Guidelines for clinical electroencephalography: Russian professional community development and consensus building

Clinical guidelines based on scientific data are mandatory for clinical practice. However, they only indicate the necessity of diagnostic tests and do not describe how to perform them. Additional methodological documents are therefore necessary to standardize diagnostic and therapeutic processes. The Association of Clinical Neurophysiology Specialists (ASCLIN), in collaboration with the Russian Association of Functional Diagnostics Physicians (RASFD), the All-Russian Society of Neurologists, and the Russian Anti-Epilepsy League (RAEL), has developed methodological guidelines for EEG and EEG with stress tests. Since this term, used in the nomenclature of medical services, is not used in practice, the recommendations use the synonym «functional tests» as the most common and understandable for personnel conducting EEG, corresponding to the English terms 'activating' and «modulating procedures.» The level of evidence was assessed using the GRADE system; more than 6000 functional diagnostics physicians and neurologists participated in the public discussion. Twenty-two recommendations were formulated, three of which are level B2 and eight of which are level C5. The document includes practical appendices with examples of standard operating procedures, a protocol for examinations during attacks, and illustrations of typical artifacts. The developed methodological guidelines align with the Ministry of Health of the Russian Federation's clinical recommendations ecosystem. They aim to standardize EEG procedures and improve diagnosis and treatment quality.