Document Type

Article

Publication Date

6-10-2025

Identifier

DOI: 10.1212/WNL.0000000000213689; PMCID: PMC12089659

Abstract

OBJECTIVES: Status epilepticus (SE) is a neurologic emergency that requires urgent recognition and medical management. SE management remains heterogeneous across centers.

METHODS: We analyzed SE treatment protocols from level 3 and level 4 epilepsy centers. Discrete data including stabilization measures, timing of treatment phases, medications, doses, and routes of administration were collected from each protocol and described using frequency for categorical variables and median for continuous variables. The distribution of treatment times and dosing were compared with the AES guideline.

RESULTS: A total of 256 SE treatment protocols were included. Only 66% of SE protocols detailed treatment times. Doses below recommendations occurred in 4% of protocols for initial benzodiazepine (BZD) and 14% for first non-BZD medications. Infusion therapy was outlined in 61% of protocols.

DISCUSSION: Despite the importance of timeliness in SE management, one third of institutional protocols did not specify treatment times. This analysis of US hospital inpatient SE protocols provides expert opinion regarding infusion therapy management and highlights gaps and targets for improvement in SE treatment.

Journal Title

Neurology

Volume

104

Issue

11

First Page

213689

Last Page

213689

MeSH Keywords

Status Epilepticus; Humans; Anticonvulsants; Clinical Protocols; United States; Benzodiazepines; Practice Guidelines as Topic

PubMed ID

40378375

Keywords

Status Epilepticus; Anticonvulsants; Clinical Protocols; United States; Benzodiazepines; Practice Guidelines as Topic

Comments

This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

Publisher's Link: https://doi.org/10.1212/wnl.0000000000213689

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