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Under these circumstances, BDZ therapy might not be optimal, and might be possibly detrimental, if given alone; as the duration of SE increases, so too does BDZ\u00a0resistance. Murine models of SE showed how these cases might benefit more from synergistic combined therapy from the start. The definition of Stage 1 plus is suggested, as a stage requiring combined therapy from the start, which includes prolonged SE with seizure activity going on for &gt;10\u2009min, the time that marks the disruption of receptor homeostasis, with increased internalization. This specific stage might require a synergistic approach from the start, with a combination of first\u2010 and second\u2010line treatment.<\/jats:p>","DOI":"10.1111\/epi.17953","type":"journal-article","created":{"date-parts":[[2024,3,20]],"date-time":"2024-03-20T11:29:21Z","timestamp":1710934161000},"page":"1560-1567","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Status epilepticus: Is there a Stage 1 plus?"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8187-8354","authenticated-orcid":false,"given":"Giuseppe","family":"Magro","sequence":"first","affiliation":[{"name":"Department of Medical and Surgical Sciences, Institute of Neurology Magna Gr\u00e6cia University  Catanzaro 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