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Background: Generalized convulsive status epilepticus (GCSE) is a critical condition that frequently requires intensive care unit (ICU) admission. While there is strong evidence supporting the initial management of GCSE, the optimal approach to refractory status epilepticus (RSE) and focal motor status epilepticus (SE) remains unclear. Continuous electroencephalogram (cEEG) monitoring plays a pivotal role in RSE management. However, data are lacking regarding the availability and practical use of cEEG in ICUs. This study aimed to evaluate the availability of cEEG and the potential limitations to its use in ICUs. We also assessed intensivists' training in electroencephalogram (EEG) interpretation and examined current practices in the management of GCSE, RSE, and focal motor SE within ICUs. Methods: An anonymous online questionnaire was distributed to French-speaking intensivists. The survey collected data on respondent demographics, access to intermittent and cEEG, and therapeutic strategies (including anti-seizure medications ASMs and sedatives) for different SE subtypes. Results: =133; 76.9%). After seizure control, only 52 respondents routinely prescribed short-acting ASMs (30.1%), while 77 intensivists respondents (44.5%) prescribed long-acting ASMs, primarily levetiracetam. Practices in the management of focal motor SE were highly variable. Conclusion: This study comprehensively explored both therapeutic management and EEG monitoring strategies for SE subtypes in French-speaking ICUs. Significant gaps exist between guidelines and real-life practice, particularly in RSE and focal motor SE management. Improved training, collaboration, and research are essential to optimize outcomes.
Fanet et al. (Tue,) studied this question.