The technique of EEG biofeedback training was first used therapeutically for epilepsy, and the scientific literature is most extensive for this condition, dating back to the early 1970's. EEG biofeedback has been shown to be helpful for all kinds of epilepsy, including petit mal, grand mal, and complex partial seizures. A variety of training protocols has been used successfully. However, the technique did not become widely accepted. This is ascribed to the fact that initially the training took a very long time, was not widely available, and was very expensive. Also, there was no agreement on a model of efficacy.

Recent progress in instrumentation and in methodology has made the training much more economical. However, there remains a large variety of outcomes. In some cases, the client may respond dramatically in just a few sessions. In other cases, the training remains long-term, requiring on the order of 80-100 training sessions. EEG biofeedback may also need to be complemented with other approaches, such as lifestyle changes which avoid those conditions which effect a lowering of seizure threshold. Also, active interventions may be learned which can serve to abort incipient seizures. Finally, determination of dietary susceptibilities may be important, insofar as there are a number of substances which may alter the seizure threshold adversely.

EEG biofeedback should therefore be considered as an element of a comprehensive program of management of epilepsy which includes pharmacological intervention, dietary sensitivity analysis, and consideration of lifestyle issues which are found to impinge on seizure susceptibility in a particular case. It is found that epilepsy is highly susceptible to many behavioral variables over which the client may exercise a large measure of control.

In many cases of epilepsy, pharmacological intervention is sufficient to achieve seizure control. However, other behavioral correlates are still observed. In other cases, the anticonvulsant medication may be accompanied by significant side effects on the client's mood, sleep, mental alertness, and cognitive ability. The behavioral consequences appear to be associated with what is most likely "sub-clinical seizure activity", namely cortical disturbances which are qualitatively similar to seizure phenomena, but not quantitatively sufficient to result in a well-defined seizure. These phenomena are what the neurologist looks for in a clinical EEG, or electroencephalogram.

EEG biofeedback is likely to achieve regulation of such behavioral disturbances even before an improvement in seizure incidence is observed. EEG biofeedback training may also be used to reduce the medication dose required to achieve seizure control, and hence reduce the side effects attributable to such medication. Persons under medication must remain under the active supervision of their prescribing physician as they undergo the training. Following the advice of the prescribing physician is particularly important because of the potential need to adjust the medication as the training proceeds.

In many cases of epilepsy in young children, the cause may be a difficult birth, even though the seizures don't manifest until later stages of cortical maturity. In these cases, there may be other deficits in the child's functioning which are also attributable to the traumatic birth (mood disorders, sleep disorders, learning disabilities, attention deficits), which may also respond to the EEG training.