{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T20:18:29Z","timestamp":1779913109606,"version":"3.53.1"},"reference-count":39,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T00:00:00Z","timestamp":1743379200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Purpose<\/jats:title><jats:p>To explore specialists\u2019 opinions on the current management of pediatric convulsive status epilepticus (CSE) in Italy and the main factors influencing the applicability of guidelines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a national survey of child neurologists, pediatric emergency physicians, and intensivists. Within the multidisciplinary Italian Paediatric Status Epilepticus (IPSE) Group, a web\u2010based 48\u2010multiple\u2010choice questionnaire was developed to explore treatment choices, use of internal protocols and guidelines, and self\u2010perceived competencies in the treatment of CSE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Responses were received from 250 clinicians from 34 Italian hospitals (response rate 71%). Intravenous midazolam (iv\u2010MDZ) was the preferred benzodiazepine (BDZ) when iv access was available (90%). When iv\u2010access was unavailable, 75% of clinicians used BDZs; rectal diazepam was the most indicated (65.6%). Concerning second\u2010line treatment, the choices were equally distributed between phenytoin (55.2%), levetiracetam (52.4%), and phenobarbital (52.4%). MDZ infusion at a dosage &lt; 0.23\u00a0mg\/kg\/h was also a frequent choice (38%). A PICU in the hospital influenced this latter choice, resulting in a significantly greater use of iv\u2010MDZ by pediatric emergency physicians working in these hospitals. Answers\u2019 variability was related to organizational aspects such as the availability of on\u2010duty specialists and diagnostic tools in emergency settings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This survey confirmed that first\u2010line treatment of pediatric CSE relied on iv\u2010MDZ and that the heterogeneity of therapeutic choices started from the second\u2010line treatment in real life. The survey also highlighted the need to consider the organizational heterogeneity among settings and to involve different specialties in an integrated and feasible approach.<\/jats:p><\/jats:sec>","DOI":"10.1002\/brb3.70433","type":"journal-article","created":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T23:09:09Z","timestamp":1743548949000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["An Italian Survey on the Management of Pediatric Convulsive Status Epilepticus: More Than Just a Pharmacological Choice"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7235-4965","authenticated-orcid":false,"given":"Caterina","family":"Zanus","sequence":"first","affiliation":[{"name":"Institute for Maternal and Child Health \u2010 IRCCS \u201cBurlo Garofolo\u201d \u2010 Trieste Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Cannizzaro","sequence":"additional","affiliation":[{"name":"Paediatric Neurology Unit, Meyer Children's Hospital IRCCS University of Florence Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo","family":"Danieli","sequence":"additional","affiliation":[{"name":"Unit of Biostatistics, Epidemiology and Public Health, Department of Cardio\u2010Thoraco\u2010Vascular Sciences and Public Health University of Padua Padua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Amigoni","sequence":"additional","affiliation":[{"name":"Paediatric Intensive Care Unit,\u00a0Department of Woman's\u00a0and Child's Health University Hospital\u00a0of Padova Padua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Buratti","sequence":"additional","affiliation":[{"name":"Neonatal and Paediatric Intensive Care Unit,\u00a0Emergency Department IRCCS Istituto Giannina Gaslini Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Izzo","sequence":"additional","affiliation":[{"name":"Paediatric Intensive Care Unit Buzzi Children's Hospital Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Mastrangelo","sequence":"additional","affiliation":[{"name":"UOC Terapia Intensiva Pediatrica Pre Post Chirurgica IRCCS Policlinico San Donato San Donato Milanese Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Cristina","family":"Mondardini","sequence":"additional","affiliation":[{"name":"Paediatric Anaesthesia and Intensive Care Unit IRCCS AOUBO Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Costa","sequence":"additional","affiliation":[{"name":"Institute for Maternal and Child Health \u2010 IRCCS \u201cBurlo Garofolo\u201d \u2010 Trieste Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8754-7214","authenticated-orcid":false,"given":"Anna","family":"Rosati","sequence":"additional","affiliation":[{"name":"Paediatric Neurology Unit, Meyer Children's Hospital IRCCS University of Florence Florence Italy"},{"name":"Child Neuropsychiatry, Department of Paediatrics Santa Chiara Hospital, Azienda Provinciale per i Servizi Sanitari Trento Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla","family":"Marini","sequence":"additional","affiliation":[{"name":"Child Neurology and Psychiatric Unit, Paediatrics Hospital G. 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