Evidence map›Paper›PMID 40190590›Full record

ArticleNeurology. Clinical practice2025

Assessment of Seizure Action Plans in Pediatric Convulsive Status Epilepticus: Focus on Benzodiazepine-Responsive and Resistant Cases.

Coral M Stredny, Sahar Rostamian, Theodore Alexander Sheehan, Marina Gaínza-Lein, Shannon Carey, Samuel Lewis, Justice Clark, Bethany Bucciarelli, Madeline Chiujdea, Annalee Antonetty and 4 more

Abstract read
In one paragraph

Article in Neurology. Clinical practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Coral M StrednyDivision of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, MA.ORCID https://orcid.org/0000-0003-1176-640X
Sahar RostamianDivision of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, MA.ORCID https://orcid.org/0000-0003-4182-6004
Theodore Alexander SheehanDivision of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, MA.ORCID https://orcid.org/0000-0002-8059-9388
Marina Gaínza-LeinInstitute of Pediatrics, Faculty of Medicine, Universidad Austral de Chile.ORCID https://orcid.org/0000-0001-9175-9458
Shannon CareyDivision of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, MA.ORCID https://orcid.org/0009-0007-8209-3528
Samuel LewisDepartment of Emergency Medicine, University of Washington, Seattle, WA; and.ORCID https://orcid.org/0000-0001-5649-6584
Justice ClarkDivision of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, MA.ORCID https://orcid.org/0000-0003-0711-3043
Bethany BucciarelliDivision of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, MA.ORCID https://orcid.org/0009-0006-3552-245X
Madeline ChiujdeaDivision of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, MA.ORCID https://orcid.org/0000-0002-5832-7669
Annalee AntonettyDivision of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, MA.ORCID https://orcid.org/0000-0001-9127-5760
Bo ZhangDepartment of Neurology and Biostatistics and Research Design Center, Boston Children's Hospital, Harvard Medical School, MA.ORCID https://orcid.org/0000-0003-1574-198X
Luisa Fernanda Atunes OrtegaDivision of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, MA.ORCID https://orcid.org/0009-0007-5832-3362
Lillian VokeDivision of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, MA.ORCID https://orcid.org/0009-0009-7406-3673
Tobias LoddenkemperDivision of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, MA.ORCID https://orcid.org/0000-0003-2074-0674

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background and Objectives: Optimal acute treatment is crucial in pediatric convulsive status epilepticus (CSE). However, data on the benefits of seizure action plans (SAPs) and treatment algorithm implementation in relation to process and outcome measures in CSE are scarce. Our study examines treatment algorithm adherence in benzodiazepine (BZD)-responsive and BZD-resistant groups and specifically focuses on the relationship with personalized SAPs. Methods: We performed a prospective observational cohort study evaluating patient care processes and outcomes in young patients with CSE lasting ≥5 minutes, requiring admission and an antiseizure medication(s) (ASM) for seizure termination from February 2016 to July 2018. Patients with infantile spasms, invasive EEG monitoring, unclear seizure duration, unclear ASM administration time, or seizure cluster were excluded. We used univariate statistics to analyze the data. Results: We enrolled 60 patients (median age 3.7 [1.9-7.0] years, 48% female), including 34 BZD-responsive and 26 BZD-resistant patients. Patients who had access to a personalized SAP, even if it was not adhered to, experienced a median (p25-p75) time to first ASM of 6 minutes (5-18; n = 34). By contrast, patients without access to a personalized SAP had a longer median (p25-p75) time to the first ASM of 15 minutes (8-27; n = 24; Discussion: Seizure duration was shorter in patients with personalized SAP, and the time to administer ASM was faster. In addition, BZD-resistant patients were less likely to follow treatment protocols, and the time to first-line therapy was slower. SAP and algorithm implementation was associated with a lower intubation rate, indicating potential benefits, including improved process and patient outcome measures.

Identifiers

PMID40190590
PMCPMC11966521

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.