{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T03:28:38Z","timestamp":1781839718477,"version":"3.54.5"},"reference-count":39,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:00:00Z","timestamp":1775088000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:00:00Z","timestamp":1775088000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epileptic Disorders"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To describe clinical phenotypes of organophosphate (OP)\u2010related status epilepticus (SE) and to determine whether they could represent a real\u2010world model of Stage 1 Plus SE, a stage possibly requiring early polytherapy from the start.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a systematic review, searching PubMed and Scopus, complemented by Google Scholar and reference\/citation screening to find human OP\u2010related SE. Two reviewers independently screened records, extracted patient\u2010level data, and appraised methodological quality following the PRISMA guidelines; disagreements were resolved by consensus. Studies including single epileptic seizures not meeting the International League Against Epilepsy (ILAE) criteria for SE were excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twelve cases met the inclusion criteria. A specific OP agent was identified in 7\/12. Convulsive SE was reported in 8\/12, while nonconvulsive and myoclonic SE were documented in a minority of cases; phenotypes could overlap. SE onset after exposure ranged from 2 to 36\u2009h, with one case linked to chronic intoxication. Concomitant cholinergic features were reported in almost all cases (11\/12). Seizure persistence after an initial benzodiazepine (BDZ) bolus was reported in all cases in which a first\u2010line BDZ bolus was administered (7\/7), prompting a sequential shift to antiseizure medications or anesthetic agents. Mechanical ventilation was required in 11\/12; reported outcomes were favorable in 11\/12.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>OP poisoning is a polymorphic entity including several cholinergic features and a broad SE spectrum, mainly convulsive SE. Ongoing seizures after early BDZ therapy suggest a possible direction toward a Stage 1 Plus phenotype, mirroring experimental evidence from preclinical animal models of OP\u2010induced SE, possibly requiring early polytherapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epd2.70240","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T14:15:02Z","timestamp":1775139302000},"page":"846-854","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A systematic review of human status epilepticus in organophosphate poisoning: A real\u2010world Stage 1 Plus model?"],"prefix":"10.1002","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8187-8354","authenticated-orcid":false,"given":"Giuseppe","family":"Magro","sequence":"first","affiliation":[{"name":"Department of Neurology \u201cGiovanni Paolo II\u201d Hospital  Lamezia Terme Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oreste","family":"Marsico","sequence":"additional","affiliation":[{"name":"Department of Neurology \u201cGiovanni Paolo II\u201d Hospital  Lamezia Terme Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,2]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(07)61202\u20101"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.emc.2014.09.010"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.61.5.649"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/epi4.12713"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1212\/cpj.0000000000000641"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.13695"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528\u20101167.2011.03243.x"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41582\u2010022\u201000664\u20103"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/epi4.12718"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2019.06.011"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1523\/jneurosci.4944\u201004.2005"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2020.107229"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.17953"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/neurolint17010011"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mehy.2026.111894"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2023.07.022"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2021.117368"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.18493"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.13121"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.18338"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.15406\/mojcr.2016.04.00106"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.4103\/0971\u20106580.172283"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.5001\/omj.2028.34"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.14744\/epilepsi.2019.22755"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/bcr\u20102022\u2010253435"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12098\u2010015\u20101813\u20104"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1080\/20469047.2022.2108671"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.3126\/jnps.v34i3.10497"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/emp2.12859"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(20)32644\u20101"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.toxrep.2025.102106"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/676358"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.0000000000214624"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.14500"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuropharm.2020.108444"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2025.03.011"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.13480"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nbd.2017.04.019"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2015.05.007"}],"container-title":["Epileptic 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