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Initiation of antiseizure medications varies widely among neurologists following a first unprovoked seizure with nonspecific EEG abnormalities, according to results published in Neurology Clinical Practice. Steven Tobochnik, MD, and colleagues surveyed US neurologists (N=106) to assess patterns related to antiseizure medication initiation. Most respondents (75% to 95%) said they would initiate antiseizure medications for definite epileptiform features on EEG. The study team noted greater variability for nonspecific EEG abnormalities; sharply contoured activity, sharp transients, and focal delta slowing were associated with the most variability and uncertainty. Neurologists with more than 5 years of experience (P=0.021), subspecialty EEG training (P<0.001), and greater confidence in EEG interpretation (P=0.001) were less likely to start antiseizure medications for two or more nonspecific EEG abnormalities and reported greater uncertainty. In multivariate analysis, the study team found an association between seniority (P= 0.039) and subspecialty EEG training (P=0.032) with lower initiation of antiseizure medications for nonspecific EEG features.