Frontiers in neurology · 2026
Video-EEG/polygraphy in status epilepticus.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
d'Orsi Giuseppe, Di Claudio Maria Teresa, Costantino Umberto, Ferro Carmela Pia
Аннотация
BACKGROUND: The management of Status Epilepticus (SE) is anchored by time-dependent protocols, recognizing that time is the primary prognostic determinant. Acute care application is complicated by critical diagnostic ambiguities, risking delays and therapeutic errors. This narrative analysis highlights the role of continuous Video-EEG/Polygraphy (V-EEG/PG) in resolving key practical challenges in SE management.
METHODS: We conducted a retrospective narrative analysis of five illustrative clinical vignettes from a tertiary-care center. Cases were selected to address the three major management challenges: Time (Nonconvulsive SE vs. stupor), Etiology (SE vs. Toxic-Metabolic Encephalopathies), and Differential Diagnosis (seizures vs. behavioral mimics). The V-EEG/PG utility was assessed based on its capacity to provide objective electro-clinical correlation, guiding timely therapeutic escalation or de-escalation.
RESULTS: V-EEG/PG provided critical clinical insights by: (1) Objectively Confirming Cessation, preventing silent progression to Refractory SE. (2) Guiding Etiological Triage, aiding in the exclusion of SE/NCSE in metabolic disease, avoiding the harmful use of high-dose Anti-Seizure Medications and unnecessary anesthetic exposure. (3) Ensuring Diagnostic Accuracy, serving as highly reliable standard for differentiating true SE from mimics, thus safeguarding patients from chronic misdiagnosis and pharmacological toxicity.
CONCLUSION: Effective SE management should ideally incorporate a shift from a purely chronological approach to an electro-clinical strategy. Continuous V-EEG/PG is a pivotal diagnostic asset that resolves key ambiguities. The evidence suggests that V-EEG/PG should be considered a standard of care in specific high-risk and ambiguous acute care settings, particularly in patients with stupor/coma post-treatment, altered mental status in metabolic disease, or prolonged, non-stereotyped motor events.
METHODS: We conducted a retrospective narrative analysis of five illustrative clinical vignettes from a tertiary-care center. Cases were selected to address the three major management challenges: Time (Nonconvulsive SE vs. stupor), Etiology (SE vs. Toxic-Metabolic Encephalopathies), and Differential Diagnosis (seizures vs. behavioral mimics). The V-EEG/PG utility was assessed based on its capacity to provide objective electro-clinical correlation, guiding timely therapeutic escalation or de-escalation.
RESULTS: V-EEG/PG provided critical clinical insights by: (1) Objectively Confirming Cessation, preventing silent progression to Refractory SE. (2) Guiding Etiological Triage, aiding in the exclusion of SE/NCSE in metabolic disease, avoiding the harmful use of high-dose Anti-Seizure Medications and unnecessary anesthetic exposure. (3) Ensuring Diagnostic Accuracy, serving as highly reliable standard for differentiating true SE from mimics, thus safeguarding patients from chronic misdiagnosis and pharmacological toxicity.
CONCLUSION: Effective SE management should ideally incorporate a shift from a purely chronological approach to an electro-clinical strategy. Continuous V-EEG/PG is a pivotal diagnostic asset that resolves key ambiguities. The evidence suggests that V-EEG/PG should be considered a standard of care in specific high-risk and ambiguous acute care settings, particularly in patients with stupor/coma post-treatment, altered mental status in metabolic disease, or prolonged, non-stereotyped motor events.