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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Legriel Stéphane retweeted
A scoping review of ictal affective symptoms in focal #epilepsy found that seizure onset was most commonly localized to limbic networks, particularly in the temporal lobe, followed by the frontal lobe.
doi.org/10.1002/epd2.70438
@EpiDisorders
🧠❤️ 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
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
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
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
Legriel Stéphane retweeted
1/ Hello #medtwitter #medsky #neurotwitter #neurosky #neurocritcare #FOAMEd #MEdEd, today we will be breaking down another article from @neurocritcarej about 🧠 O2 after cardiac arrest!
link.springer.com/article/10…
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…
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
Legriel Stéphane retweeted
The final Part of our rapid #EEG "POC" series with @DrHirschEEG is out! 👇🧠⚡️ @fabnascimen
youtu.be/eDky6g5UJIE
Legriel Stéphane retweeted
Check out our newest paper here 👇🏻 doi.org/10.1002/phar.70198
Could enteral vigabatrin become an option for post-anoxic #statusepilepticus?
In 6 comatose patients with electrographic SE, loading doses achieved measurable absorption despite critical illness.
A first PK step — not evidence of efficacy.
doi.org/10.1002/phar.70198
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…
Legriel Stéphane retweeted
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…
“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
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.
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/…
Legriel Stéphane retweeted
Salsburg EEG criteria for classification of Non-convulsive status epilepticus:
#neurowalid #neurotip #epilepsy
From: emcrit.org/ibcc/ncse/
Legriel Stéphane retweeted
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