Nasopharyngeal electrodes in temporal lobe epilepsy: A reappraisal of their diagnostic utility

•The diagnostic sensitivity of nasopharyngeal electrodes (NPE) recordings was superior to that of non-NPE recordings for the detection of interictal epileptiform discharges (IED) in temporal lobe epilepsy (TLE).•Detection rate of bilateral IEDs was higher for NPE than for non-NPE recordings.•Degree of agreement for IED detection was higher for NPE than for non-NPE recordings. To compare electroencephalography (EEG) recordings with nasopharyngeal electrodes (NPEs) plus anterior temporal electrodes (ATEs) (NPE recordings) and those with only ATEs (non-NPE recordings) for the detection of interictal epileptiform discharges (IEDs) in patients with suspected temporal lobe epilepsy (TLE). We retrospectively analyzed the initial EEGs of 229 patients that were recorded simultaneously with ATEs and NPEs in addition to the electrodes of the 10–20 system of electrode placement. Two data sets of NPE and non-NPE recordings were reviewed independently by three interpreters with differing degrees of experience. Discordant findings in the interpretation among the three interpreters were resolved by a consensus to yield final results. IEDs were detected in 76.4% of patients with NPE recordings compared to 55.5% with non-NPE recordings (p