{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T23:53:40Z","timestamp":1793490820027,"version":"4.5.0"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T00:00:00Z","timestamp":1762128000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Status epilepticus (SE) is a life-threatening neurological emergency, and exhibits significant variability in clinical management despite established guidelines. This study evaluates current practices across German speaking countries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A web-based survey (December 2023\u2013May 2024) assessed SE treatment strategies among 83 neurologists and neurointensivists from Germany, Austria, and Switzerland. Cases were presented to analyze diagnostic and therapeutic preferences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The preferred benzodiazepine for first line treatment was lorazepam, chosen by 71.6% of the respondents. In the case of established SE, 35.4% chose levetiracetam as the preferred ASM. Propofol in combination with sufentanil\/fentanyl was the preferred anesthetic of choice in 65.4% of respondents. For super-refractory status epilepticus (SRSE), 41.5% prefer to add further ASM, with valproic acid (67.1%), and lacosamide (64.5%) being the most frequently selected. Only 31.8% reported that their emergency services have a standard operating procedure (SOP) for SE treatment, and the choice of the preferred benzodiazepine varied in the preclinical setting, with midazolam being the most commonly used. 1)\n                      <jats:italic>First-line therapy<\/jats:italic>\n                      : Lorazepam (71.6% in-hospital), midazolam (50% prehospital), 2)\n                      <jats:italic>Second-line therapy<\/jats:italic>\n                      : Levetiracetam (35.4%) and lacosamide (13.4%) were the most common choices, 3)\n                      <jats:italic>Refractory SE<\/jats:italic>\n                      : Propofol with opioids (65.4%) were preferred for anesthesia, 4)\n                      <jats:italic>Prehospital care<\/jats:italic>\n                      : 31.8% of emergency services lacked standardized protocols; midazolam dosing varied widely (2\u201310\u202fmg).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Diagnostics<\/jats:title>\n                    <jats:p>Laboratory testing was universal (96.9%), but MR-imaging (10%) and clinical use of prognostic scores (6.2%) were underutilized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This survey highlights the variability in clinical practice for managing status epilepticus in German-speaking countries. Persistent heterogeneity in SE management underscores the need for standardized protocols, particularly in prehospital care and refractory SE therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2025.1685993","type":"journal-article","created":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T05:22:05Z","timestamp":1762147325000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Treating status epilepticus in clinical practice\u2014a multi-national survey in Germany, Austria, and Switzerland"],"prefix":"10.3389","volume":"16","author":[{"given":"Leona","family":"M\u00f6ller","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Urs","family":"Fisch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena","family":"Habermehl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"J\u00fcnemann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,3]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"714","DOI":"10.1046\/j.1528-1157.2001.01101.x","article-title":"Incidence of status epilepticus in adults in Germany: a prospective, population-based 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