EEG on TV Shows: How Real Is It?
Medical technology in television is not always known for being accurate.
An example of this is the famously overused defibrillator paddles bringing someone back after flatlining. This is not only inaccurate but actually in direct opposition to what should be done. A stopped heart will not be started again using defibrillators. If flatlining, CPR would be much more effective in keeping blood and oxygen flowing...
...But the dramatic countdown to the electric shock and the anticipation of maybe pulling through is exciting!
TV can often suspend our disbelief for the sake of entertainment, but if what occurs on screen becomes too unbelievable, a suspenseful moment can quickly turn the rest of the story into ostentatious shlock.
So how are electroencephalograms portrayed on television?
EEGs typically make an appearance whenever a character needs their brain studied. We’ve decided to look at different TV shows through the years and see if the portrayals of EEG are actually scientifically accurate or merely a prop. While your typical audience may not notice the little differences, anyone familiar with neurodiagnostics may find their representation entertaining for the wrong reasons.
So let’s explore how EEGs appear on TV shows. This list is by no means exhaustive, but it demonstrates how EEG has advanced over the years.
7 Examples of EEG Appearing on TV
St. Elsewhere, “Cora and Arnie” 11/23/1982 - Season 1, Episode 4
Since we’re starting chronologically, let’s begin with this episode of St. Elsewhere. Fans of this medical drama might remember another popular show on NBC at the time, Hill Street Blues. In this early episode, Dr. Victor Ehrlich (Ed Begley, Jr.) admires the alpha waves of a patient by the name of Lilian Rogers that appear on her EEG scan. Note the waveforms are being printed on paper! We get to see a delightful vintage EEG machine in action.
Both the doctor and patient’s family member, while regrettably in the room during the EEG, are at least whispering during the study. Dr. Ehrlich deduces that his patient didn’t have a stroke, since a part of the patient’s brain damage would show up on the EEG. The EEG could show slowing or decreased activity, but would need further testing to localize. He briefly considers a transient ischemic attack but quickly decides that’s not the cause. The science behind what he is saying isn’t false.
We do see a printout of the healthcare bill, which may provide some interesting insight as to the cost at the time. The consultation is $123.00 while the EEG is $178.00.
|The 80s were a simpler time.|
An excellent example of what NOT to do with your wires.
While this EEG isn’t completely inaccurate, Dr. Ehrlich proclaims that his patient must regularly have “good dreams” as if he can determine this from simply looking at her alpha waves. He may be joking. Alpha waves also occur during an awake state but can assist in determining sleep stages.
We do see a quick glimpse of the patient. The cable management looks a little sloppy here, and while we can’t see the top or the back of the head, the patient probably doesn’t have a full 10-20 setup. The wires seem to be tucked under the pillow.
House, “Paternity” Aired: 11/23/2004 - Season 1, Episode 2
If you’ve seen House, you know about the unorthodox approach the eponymous main character takes to helping patients. Fans of neurodiagnostics don’t have to wait long to see an EEG appear in the series. A patient suffering from night terrors and a myoclonic jerk has an EEG to determine the cause. Dr. House forcibly restrains him with leather bindings.
“EEG revealed abnormalities in your brain, caused by nerve damage in your toes” a deadpan Dr. House explains.
He then proceeds to taunt the patient and then cut off one of his big toes. Though shocking, this was all only a nightmare in the patient’s head. Nerve damage to a patient’s toes would more likely be Peripheral and not Cranial. We have found most EEG technologists are quite pleasant and refrain from torturing their patients!
Where's the keyboard and mouse?
We get a brief look at some EEG software that looks somewhat plausible. The appearance of an EEG is so quick in this episode that if you blink, you’ll miss it! The idea of using an EEG to help diagnose this patient’s problem is solid.
There is a roller coaster ride of different diagnoses, from concussions to multiple sclerosis to neurosyphilis finally leading to a final diagnosis of subacute sclerosing panencephalitis. SSPE is bilaterally synchronous, high-amplitude spikes or slow-wave bursts that often correlate with clinical myoclonus, later progressing into a burst-suppression pattern. EEG was only a stepping stone to reaching the final diagnosis.
The only equipment we see is the monitor and lots of loose wires. There’s no amplifier or EEG system to be seen unless it's hidden under a bed. It’s likely out of frame or doesn’t exist at all.
While the EEG did play a role in helping to narrow down the problem...The EEG setup seems to be overly dramatic. It may have been done on purpose to reflect the fear the patient feels - the cables are running down the patient’s face and there are again no electrodes on the top of this patient’s head. Normally cables would be run over the top of the patient’s head and bundled appropriately - and possibly secured with a headwrap. If the patient really needed to be restrained (which could be necessary but often isn’t the case) then the patient’s thrashing could surely loosen the electrode wires on his head.
If someone who has never gotten an EEG were to see this, it might frighten them!
|House's patient seen here not exactly at ease.|
Private Practice, “Can’t Find My Way Back Home” Aired: 11/18/2010 - Season 4, Episode 9
Private Practice is a spin-off of Grey’s Anatomy that started to air in 2007 on ABC. An EEG makes an appearance in an episode where a patient has had epilepsy since a car accident that happened seven years ago.
The patient’s daughter is always taking note of the time and duration of her mother’s seizures. This is a good idea for anyone who lives with a family member who has epilepsy. A written explanation of what happened before and during a seizure or what the patient’s diet consists of could provide some valuable insight for an accurate diagnosis.
Note the equipment: we see an amplifier, multiple waveforms on the monitor, and electrodes. We see an EEG technologist in the room, too. This looks like a very expensive EMU, but not an improbable one.
|Notetaking is an undervalued skill.|
Likely more expensive than the EEG in St. Elsewhere.
Amelia Shepherd (Caterina Scoresone), the head of Neurosurgery, is monitoring a patient during an EEG study. She says she is “stimulating different areas of the brain between electrodes until she seizes, and knowing the location of the electrode she can determine the source of the seizures on the EEG. The premise is probable, but how this is demonstrated is not. Surgery patients may have depth electrodes inserted into the brain by their neurosurgeon and the cortical stim is done to trigger seizures in order to determine the focus area, but the patient only has a scalp EEG.
A tonic-clonic seizure causes the patient to have strong convulsions - during which Amelia exclaims she “located” the lesion. While EEGs are wonderful devices, they cannot pinpoint the exact location on the brain of a problem to the degree that this program illustrates...especially not with a scalp EEG like the patient is using.
Grey’s Anatomy, “One Step Too Far” Aired: 03/15/2012 - Season 8, Episode 17
Grey’s Anatomy actually premiered in 2005 before its spin-off, Private Practice. An episode we found featuring EEG premiered in 2012, although there may have been other appearances. The long-running medical TV drama (with a heavy emphasis on the personal relationships of the doctors) is still currently on-air in 2021 with another season on the way.
In this episode, a family member is distraught about his partner on life support. While initially ready to let him go, he changes his mind and asks for doctors to do their best to help revive him. Dr. Cristina Yang (Sandra Oh) tries to explain to the man that his partner is already past saving and that it’s time to let him go.
A different patient's EEG data.
She uses an EEG scan from another patient in a coma to demonstrate the lack of brain activity in his partner compared to the document she’s holding. As there has been no brain activity for the last 72 hours, the patient on the ventilator has no chance of recovery. While Grey’s Anatomy doesn’t often go into detail regarding the core medical theme of its show since it's more focused on relationships, the science behind the scene is sound. The patient is using a sort of EEG cap, so we see a different kind of setup.
We could be looking at a HIPAA violation here. Showing one patient another patient’s medical information without consent is an example. Perhaps if the information was anonymized it wouldn’t violate HIPAA. We aren’t able to zoom and enhance enough to see if there is personally identifying information on the chart, but as a word of caution, anyone who works with medical data should take care not to violate the privacy of others.
|EEG software can be seen in the background.|
The Big Bang Theory, “The Anxiety Optimization” Aired: 01/29/2015 - Season 8, Episode 13
Premiering on CBS in 2007, The Big Bang Theory isn’t a medical drama, but a comedy. One of the main characters, Sheldon Cooper (Jim Parsons), is a socially awkward and nerdy theoretical physicist. He participates in an experiment at the behest of his love interest Amy Farrah Fowler (Mayim Bialik). While the show is lighthearted, EEG technologists may have been pleased to see an EEG but slightly annoyed about its use.
Sheldon is using an EEG cap to experiment with elevated anxiety levels. The goal is to see the optimal amount of anxiety required to boost brain function. While it may seem silly, the use of an EEG for researching anxiety levels is real. We are seeing another example of an EEG cap and the wires are at least somewhat bundled and not in his eyes.
Sheldon appears to be wearing the cap incorrectly, and thanks to his constant movement the electrode positions would be off as the cap is sliding off of his head. (We suppose this is an example of very ambulatory EEG) There would likely be a large number of artifacts on the collected data. The leads are not properly secured together to increase Common Mode Rejection.
If you note the software on the monitor, there are only 4 channels seen for review, despite the fact that the entire cap appears to have more electrodes and leads in place.
We understand this is a comedy and the situation is designed for laughs, but EEG technologists long awaiting the worldly recognition they deserve won’t see accurate representation here, either. We had higher hopes for a show that elevated nerd culture, but we'll need to wait a bit longer.
Stranger Things, “Holly, Jolly” Aired: 07/15/2016 - Season 1, Episode 3 (Eleven)
Stranger Things, “The Mind Flayer” Aired: 10/27/2017 - Season 2, Episode 8 (Will)
Eleven's hair would be easy to work with.
One of Netflix’s many original programs, Stranger Things is about a girl with psychokinetic abilities raised in a secret testing facility. This show takes place in the 1980s so EEG technology would be around the same as St. Elsewhere but the device shown looks different. We found a few uses of EEG in this show. Both Eleven (Millie Bobby Brown) and Will Byers (Noah Schnapp) have EEGs.
Eleven has an EEG to test her psychokinetic abilities. Since these do not exist in reality, it would be interesting to see how an EEG would display that information! Will gets an EEG after behaving strangely because he became possessed by the Mind Flayer and is becoming a part of the hive mind. Most EEG technologists were probably not trained to look for Mind Flayer possession abnormalities as it is not present in their textbooks, but Eleven’s EEG is probably more plausible in revealing the secrets to unlocking psychokinetic powers. At the very least, other characters’ motivations for using an EEG are sound.
|Secret government facility EEG only displays one waveform?|
Watch this scene to see a bit of EEG prep work!
We see multiple electrodes applied, but only one channel displayed once again. Perhaps Hollywood has an issue showing all of the proper channels? Eleven’s EEG appears to be a cap, and is wearing in about the right spot.
Will’s electrodes are not in the correct position. Whoever his doctor is, Will may be better off finding a new one. On the bright side, we see a passing glimpse at preparation for an EEG. Someone is using a pen to mark the locations (incorrectly) of where electrodes are to be placed. Typically we don’t see that part and electrodes are already placed on a patient’s head.
Get Well Soon Hospital, “EEG” Aired: 08/18/2017
This is a children’s TV show made for the United Kingdom that teaches youngsters about medical conditions using colorful puppets and fun songs. During our research, we stumbled upon this show with an episode named “EEG” so we couldn’t help but watch it. The main character, Dr. Ranj (Ranj Singh), works at a children’s hospital and demonstrates common procedures on puppets so that the viewers are more at ease when they actually have to visit the hospital and learn something new.
Since the show is meant for children, the explanation is very simple and portrays EEGs in a positive light. This would actually be a good resource for young patients to watch prior to getting an EEG, so they know what to expect. EEG technologists that work with children may appreciate the terminology used to simplify this complex neurodiagnostic procedure for a child’s mind. If you would like to watch it, you may need access to the BBC's website from a United Kingdom IP address, so EEG technologists elsewhere will need to get creative.
There isn’t much to dislike about this 10-minute episode. If we had to find any fault in it, it could be worth mentioning that patients might have to smell unpleasant electrode paste or some other adhesive during their procedure. We’re not going to be as strict on a children’s TV that has the admirable purpose of educating young patients!
These are only a few examples of EEG on television. Overall we think EEG is represented somewhat accurately on TV, but there is room for improvement. Routine or Long Term Monitoring EEGs may not often be dramatic, but we’ve spoken to a few EEG technologists who have their share of unforgettable stories.