{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T06:18:26Z","timestamp":1771395506561,"version":"3.50.1"},"reference-count":12,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"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>The management of Status Epilepticus (SE) is anchored by time-dependent protocols, recognizing that time is the primary prognostic determinant. Acute care application is complicated by critical diagnostic ambiguities, risking delays and therapeutic errors. This narrative analysis highlights the role of continuous Video-EEG\/Polygraphy (V-EEG\/PG) in resolving key practical challenges in SE management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective narrative analysis of five illustrative clinical vignettes from a tertiary-care center. Cases were selected to address the three major management challenges: Time (Nonconvulsive SE vs. stupor), Etiology (SE vs. Toxic-Metabolic Encephalopathies), and Differential Diagnosis (seizures vs. behavioral mimics). The V-EEG\/PG utility was assessed based on its capacity to provide objective electro-clinical correlation, guiding timely therapeutic escalation or de-escalation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>V-EEG\/PG provided critical clinical insights by: (1) Objectively Confirming Cessation, preventing silent progression to Refractory SE. (2) Guiding Etiological Triage, aiding in the exclusion of SE\/NCSE in metabolic disease, avoiding the harmful use of high-dose Anti-Seizure Medications and unnecessary anesthetic exposure. (3) Ensuring Diagnostic Accuracy, serving as highly reliable standard for differentiating true SE from mimics, thus safeguarding patients from chronic misdiagnosis and pharmacological toxicity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Effective SE management should ideally incorporate a shift from a purely chronological approach to an electro-clinical strategy. Continuous V-EEG\/PG is a pivotal diagnostic asset that resolves key ambiguities. The evidence suggests that V-EEG\/PG should be considered a standard of care in specific high-risk and ambiguous acute care settings, particularly in patients with stupor\/coma post-treatment, altered mental status in metabolic disease, or prolonged, non-stereotyped motor events.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1776158","type":"journal-article","created":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T05:33:53Z","timestamp":1771392833000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Video-EEG\/polygraphy in status epilepticus"],"prefix":"10.3389","volume":"17","author":[{"given":"Giuseppe","family":"d\u2019Orsi","sequence":"first","affiliation":[{"name":"Neurology Unit \u2013 Epilepsy Center, Fondazione IRCCS Casa Sollievo della Sofferenza","place":["San Giovanni Rotondo (FG), Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Teresa","family":"Di Claudio","sequence":"additional","affiliation":[{"name":"Neurology Unit \u2013 Epilepsy Center, Fondazione IRCCS Casa Sollievo della Sofferenza","place":["San Giovanni Rotondo (FG), Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Umberto","family":"Costantino","sequence":"additional","affiliation":[{"name":"Neurology Unit \u2013 Epilepsy Center, Fondazione IRCCS Casa Sollievo della Sofferenza","place":["San Giovanni Rotondo (FG), Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmela Pia","family":"Ferro","sequence":"additional","affiliation":[{"name":"Neurology Unit \u2013 Epilepsy Center, Fondazione IRCCS Casa Sollievo della Sofferenza","place":["San Giovanni Rotondo (FG), Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,18]]},"reference":[{"key":"ref1","article-title":"Time is brain: treating status epilepticus","volume":"20","author":"Ruegg","year":"2018","journal-title":"Epigraph"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1016\/j.seizure.2019.10.006","article-title":"Medical management of status epilepticus: emergency room to intensive care unit","volume":"75","author":"Crawshaw","year":"2020","journal-title":"Seizure"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1001\/jamaneurol.2017.4382","article-title":"Association of Time to treatment with short-term outcomes for pediatric patients with refractory convulsive status epilepticus","volume":"75","author":"Ga\u00ednza-Lein","year":"2018","journal-title":"JAMA Neurol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1016\/j.yebeh.2018.09.046","article-title":"Cost of status epilepticus: effects of delayed treatment and SE duration","volume":"89","author":"Santamarina","year":"2018","journal-title":"Epilepsy Behav"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"454","DOI":"10.1212\/CON.0000000000000716","article-title":"Epilepsy emergencies: status epilepticus, acute repetitive seizures, and autoimmune encephalitis","volume":"25","author":"VanHaerents","year":"2019","journal-title":"Continuum (Minneap Minn)"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1515","DOI":"10.1111\/epi.13121","article-title":"A definition and classification of status epilepticus\u2013report of the ILAE task force on classification of status epilepticus","volume":"56","author":"Trinka","year":"2015","journal-title":"Epilepsia"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"106675","DOI":"10.1016\/j.yebeh.2019.106675","article-title":"Management of status epilepticus in adults. Position paper of the Italian league against epilepsy","volume":"102","author":"Minicucci","year":"2020","journal-title":"Epilepsy Behav"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1097\/WNP.0000000000000166","article-title":"Consensus statement on continuous EEG in critically ill adults and children, part I: indications","volume":"32","author":"Herman","year":"2015","journal-title":"J Clin Neurophysiol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1006\/ebeh.2000.0100","article-title":"Presentation, evaluation, and treatment of nonconvulsive status epilepticus","volume":"13","author":"Drislane","year":"2008","journal-title":"Epilepsy Behav"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"2059","DOI":"10.1007\/s00134-013-2938-4","article-title":"Recommendations on the use of EEG monitoring in critically ill patients: consensus statement from the neurointensive care committee of the European Society of Intensive Care Medicine (ESICM)","volume":"41","author":"Claassen","year":"2015","journal-title":"Intensive Care Med"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1097\/WNP.0b013e3182784729","article-title":"American clinical neurophysiology society's standardized critical care EEG terminology: 2012 version","volume":"30","author":"Hirsch","year":"2013","journal-title":"J Clin Neurophysiol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1111\/epi.12106","article-title":"Management of psychogenic nonepileptic seizures","volume":"54","author":"LaFrance","year":"2013","journal-title":"Epilepsia"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1776158\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T05:33:55Z","timestamp":1771392835000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1776158\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,18]]},"references-count":12,"alternative-id":["10.3389\/fneur.2026.1776158"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2026.1776158","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,18]]},"article-number":"1776158"}}