Quantitative artifact reduction and pharmacologic paralysis improve detection of EEG epileptiform activity in critically ill patients

•Pharmacologic paralysis improves detection of EEG epileptiform activity regardless of type of movement-related artifact present.•Artifact reduction improves detection of EEG epileptiform activity as much as pharmacologic paralysis when primary source of artifact is EMG.•In the appropriate setting, both artifact reduction and paralysis facilitate identification of epileptiform activity in critically ill patients.