{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T04:14:18Z","timestamp":1788668058878,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,2,15]],"date-time":"2024-02-15T00:00:00Z","timestamp":1707955200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100001454","name":"American Epilepsy Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001454","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Acute symptomatic seizures (ASyS) and epileptiform abnormalities (EAs) on electroencephalography (EEG) are commonly encountered following acute brain injury. Their immediate and long\u2010term management remains poorly investigated. We conducted an international survey to understand their current management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The cross\u2010sectional web\u2010based survey of 21 fixed\u2010response questions was based on a common clinical encounter: convulsive or suspected ASyS following an acute brain injury. Respondents selected the option that best matched their real\u2010world practice. Respondents completing the survey were compared with those who accessed but did not complete it.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 783 individuals (44 countries) accessed the survey; 502 completed it. Almost everyone used anti\u2010seizure medications (ASMs) for secondary prophylaxis after convulsive or electrographic ASyS (95.4% and 97.2%, respectively). ASM dose escalation after convulsive ASyS depends on continuous EEG (cEEG) findings: most often increased after electrographic seizures (78% of respondents), followed by lateralized periodic discharges (LPDs; 41%) and sporadic epileptiform discharges (sEDs; 17.5%). If cEEG is unrevealing, one in five respondents discontinue ASMs after a week. In the absence of convulsive and electrographic ASyS, a large proportion of respondents start ASMs due to LPD (66.7%) and sED (44%) on cEEG. At hospital discharge, most respondents (85%) continue ASM without dose change. The recommended duration of outpatient ASM use is as follows: 1\u20133\u2009months (36%), 3\u20136\u2009months (30%), 6\u201312\u2009months (13%), &gt;12\u2009months (11%). Nearly one\u2010third of respondents utilized ancillary testing before outpatient ASM taper, most commonly (79%) a &lt;2 h EEG. Approximately half of respondents had driving restrictions recommended for 6 months after discharge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>ASM use for secondary prophylaxis after convulsive and electrographic ASyS is a universal practice and is continued upon discharge. Outpatient care, particularly the ASM duration, varies significantly. Wide practice heterogeneity in managing acute EAs reflects uncertainty about their significance and management. These results highlight the need for a structured outpatient follow\u2010up and optimized care pathway for patients with ASyS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/epi.17915","type":"journal-article","created":{"date-parts":[[2024,2,15]],"date-time":"2024-02-15T10:33:21Z","timestamp":1707993201000},"page":"909-919","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Immediate and long\u2010term management practices of acute symptomatic seizures and epileptiform abnormalities: A\n                    <scp>cross\u2010sectional<\/scp>\n                    international survey"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0552-6736","authenticated-orcid":false,"given":"Vineet","family":"Punia","sequence":"first","affiliation":[{"name":"Epilepsy Center, Cleveland Clinic Foundation  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanaya","family":"Daruvala","sequence":"additional","affiliation":[{"name":"Department of Neurology Warren Alpert School of Medicine  Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica B.","family":"Dhakar","sequence":"additional","affiliation":[{"name":"Department of Neurology Warren Alpert School of Medicine  Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5252-5376","authenticated-orcid":false,"given":"Sahar F.","family":"Zafar","sequence":"additional","affiliation":[{"name":"Department of Neurology Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1680-2302","authenticated-orcid":false,"given":"Clio","family":"Rubinos","sequence":"additional","affiliation":[{"name":"University of North Carolina  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neishay","family":"Ayub","sequence":"additional","affiliation":[{"name":"Department of Neurology Warren Alpert School of Medicine  Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6333-832X","authenticated-orcid":false,"given":"Lawrence J.","family":"Hirsch","sequence":"additional","affiliation":[{"name":"Comprehensive Epilepsy Center, Department of Neurology Yale University  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6027-9205","authenticated-orcid":false,"given":"Adithya","family":"Sivaraju","sequence":"additional","affiliation":[{"name":"Comprehensive Epilepsy Center, Department of Neurology Yale University  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for Post\u2010Acute Symptomatic 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