Professor of Critical Care Medicine | Status Epilepticus & Critical Care EEG | Medical Education & Professional Development | Research | @IctalGroup network
Versailles, France
Joined February 2026
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🧠❤️ Not every cardiac arrest starts in the heart.
Recognising a neurological cause can change diagnostic priorities, treatment and prognostic assessment.
A comprehensive review of the evidence and clinical implications.
📖 doi.org/10.1016/j.clineuro.2…
#CardiacArrest @IctalGroup
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Our multicentre data suggest early fever in CSE is more a marker of seizure intensity than an independent prognostic factor. Important caveat: observational data cannot determine whether temperature-control strategies help.
doi.org/10.1007/s12028-026-0… @NeurocritCareJ @IctalGroup
New from the ICTAL Registry: among 952 adults with convulsive #statusepilepticus , early fever occurred in 41.2% but was not independently associated with 90-day functional outcome. Fever appeared to reflect seizure intensity more than overall severity.
doi.org/10.1007/s12028-026-0…
EEG availability is not only a diagnostic issue in #statusepilepticus. This study raises an important organizational question: how can we ensure timely EEG access when it is needed?
Association is not causation, but the signal deserves attention.
doi.org/10.1136/jnnp-2026-33…
How much does access to EEG matter in #statusepilepticus?
In 163 adults with EEG-confirmed NCSE, externally validated in 906 patients, longer delays to EEG were associated with worse functional outcomes and higher mortality.
doi.org/10.1136/jnnp-2026-33…
Respiratory tract infections are a major complication of #statusepilepticus.
A 20-year longitudinal study examines their incidence, timing and association with outcomes in patients with SE.
Beyond seizure control, complications matter.
doi.org/10.1002/epi.70458
Experimental data, but a biologically important message: seizure termination and neuronal injury are not independent of time.
Translating this relationship into clinically meaningful treatment windows remains the challenge.
doi.org/10.1002/epi.70448 @EpilepsiaJourn
Does timing of treatment matter for neuronal injury in #statusepilepticus?
In an experimental rat model, early phenobarbital treatment prevented the reductions in N-acetylaspartate and neuronal loss observed after untreated SE.
doi.org/10.1002/epi.70448
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NCSE can mimic acute stroke — including with ictal paresis.
In this 6-patient series, perfusion imaging helped identify the ictal origin when EEG findings were less informative.
A rare but clinically important presentation.
doi.org/10.1016/j.seizure.20… @phi3417 @SeizureJournal
NCSE can mimic acute stroke — including with ictal paresis.
In this 6-patient series, perfusion imaging helped identify the ictal origin when EEG findings were less informative.
A rare but clinically important presentation.
doi.org/10.1016/j.seizure.20… @phi3417 @SeizureJournal
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Very proud of this work led by Sébastien Repplinger and the @IctalGroup
Beyond diagnostic yield, the key question is: does an investigation actually change what we think and what we do?
A clinically meaningful way to look at etiologic testing after #statusepilepticus 🧠⚡
🔥 New from the #ICTALRegistry in @GreenJournal !
How much do etiologic investigations actually tell us after #statusepilepticus — and how often do they change management?
Congrats to Sébastien Repplinger & the entire @IctalGroup team! 🧠⚡
DOI: 10.1212/WNL.0000000000218544
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Congratulations @epilepsiOUH !
The neuropathology of "dementia epileptica"
Read the full OA article on "Hyperphosphorylated tau pathology in patients with epilepsy and dementia"
on
sciencedirect.com/science/ar…
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An interesting perspective for #cEEG interpretation: seizure burden may not tell the whole story. The temporal organization of seizures could also carry clinically relevant information.
Early data, but a question worth exploring. #EEG #NeuroCriticalCare
doi.org/10.1097/WNP.00000000…
Could seizure timing predict response to IV antiseizure medications?
In critically ill patients undergoing #cEEG, greater seizure periodicity was associated with a lower probability of post-treatment remission.
Small, hypothesis-generating study.
doi.org/10.1097/WNP.00000000… #EEG
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SRSE is precisely where new therapeutic approaches are needed. An intriguing feasibility signal for tDCS, now requiring controlled evaluation.
doi.org/10.1186/s12883-026-0… @BioMedCentral #statusepilepticus
Can non-invasive neuromodulation play a role in Super Refractory #StatusEpilepticus #SRSE ?
In a prospective series of 20 adults, adjunctive cathodal #tDCS was feasible and well tolerated; 4/20 showed short-term clinical + EEG improvement.
@BioMedCentral
doi.org/10.1186/s12883-026-0…
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“Status non-epilepticus” is a useful and increasingly visible term for prolonged/recurrent PNES. But ot a MeSH term. Multiple labels still coexist in the literature.
Would the field benefit from a unified, officially endorsed terminology? @IlaeWeb @SBeniczky @EpiDisorders
Distinguishing between status epilepticus and seizure mimics remains a common clinical challenge, often leading to unnecessary escalation of treatment. onlinelibrary.wiley.com/doi/…
ALT Whenever possible, recording events and involving specialized professionals, such as neurologists or epileptologists, can improve diagnostic accuracy, while lack of response to standard therapies should prompt consideration of psychogenic non-epileptic seizures. Read this interesting original article at
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We recently discussed the need for OH data before extending rescue-treatment findings to #statusepilepticus. Here they are — 402 episodes meeting the >5-min definition. @EpilepsiaJourn
onlinelibrary.wiley.com/doi/…
An intriguing rescue-treatment signal, but not evidence of equivalence or a change in #StatusEpilepticus practice. This was a small, open-label, single-centre EMU trial in selected patients already taking clobazam. Out-of-hospital effectiveness still needs testing.
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We recently discussed the need for OH data before extending rescue-treatment findings to #statusepilepticus. Here they are — 402 episodes meeting the >5-min definition. Encouraging observational data, although the lack of a control group still prevents efficacy claims.
Out-of-hospital diazepam nasal spray was evaluated in 402 tonic–clonic #StatusEpilepticus episodes (>5 min): 61.7% ended before 30 min, 49.8% within 20 min of dosing, and <5% recurred within 24 h.
Retrospective pooled analysis.
@EpilepsiaJourn
onlinelibrary.wiley.com/doi/…
An intriguing rescue-treatment signal, but not evidence of equivalence or a change in #StatusEpilepticus practice. This was a small, open-label, single-centre EMU trial in selected patients already taking clobazam. Out-of-hospital effectiveness still needs testing.
Intranasal midazolam vs mouth-dissolving clobazam in terminating seizures: A randomized controlled trial dlvr.it/TVPlR4 #Neurology #Epilepsy
An important complement to recent coma studies. Confounding by indication is central: etiology, semiology and baseline severity shape both escalation and outcome. #StatusEpilepticus @EpilepsyBehavi1
In 145 adults with #StatusEpilepticus, 55% developed RSE and 47% of RSE received therapeutic coma. Worse outcomes with coma were no longer significant after adjustment, highlighting strong treatment-selection effects. @EpilepsyBehavi1
epilepsybehavior.com/article…
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A randomized high-fidelity simulation trial of 124 physicians: a one-page #StatusEpilepticus guide improved side positioning (63% vs 25% control) and second-line treatment (97% vs 70%). Information design may influence time-critical care.
link.springer.com/article/10…
In a prospective cohort of 114 Egyptian patients with #StatusEpilepticus, 55.3% had unfavourable 3-month outcomes and 36.8% died. END-IT provided only moderate prognostic performance; comorbidity burden may improve prediction. @EpilepsyBehavi1
epilepsybehavior.com/article…
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A strong warning, but also against causal overinterpretation. This retrospective study cannot eliminate confounding by indication: the sickest and most refractory patients are also the most likely to receive therapeutic coma. A signal to question practice, not proof of harm.
Therapeutic coma in NonConvulsive #statusepilepticus was associated with more pneumonia, sepsis, arrhythmias, acute kidney injury and in-hospital mortality (adjusted RR 1.86), without better seizure termination
link.springer.com/article/10…
Important findings. Etiology may be more than a prognostic marker in #statusepilepticus: it may also influence treatment responsiveness. Independent validation, integrating treatment timing and adequacy, is now needed. @EpilepsiaJourn
Why do some episodes of #statusepilepticus become refractory?
In 649 nonhypoxic SE episodes, acute primary CNS, progressive and unknown causes were associated with super-refractoriness. @EpilepsiaJourn
Etiologic granularity matters.
doi.org/10.1002/epi.70446
Major study on super-refractory #statusepilepticus. Even after >28 d of treatment, seizure cessation remained possible and mortality did not increase. Functional outcomes remain poor, but prolonged treatment should not automatically be considered futile. @JAMANeuro @epilepsiOUH
Proud to share our systematic review on outcomes and treatment approaches for super-refractory status epilepticus.
👇
jamanetwork.com/journals/jam…
