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AES 2022 | How should post-stroke seizures and epilepsy be managed?

Acute symptomatic seizures, defined as seizures occurring within 7 days of a stroke, and post-stroke epilepsy, defined as at least two unprovoked epileptic seizures occurring after the acute phase of the stroke, are common complications of stroke. Carolina Ferreira-Atuesta, MD, MSc, Icahn School of Medicine at Mount Sinai, New York, NY, outlines the current guidelines for the management of early- and late-onset seizures after stroke. Antiseizure medication (ASM) use is not recommended following seizures in the acute phase as they have not been shown to improve the risk of post-stroke epilepsy and may inhibit behavioral, motor, or cardiovascular recovery. For post-stroke epilepsy, ASM use should be initiated as in any other new onset epilepsy. Dr Ferreira-Atuesta notes the occurrence of status epilepticus in the acute phase as a potential exception, with some emerging evidence suggesting early ASM use could be beneficial. This interview took place at the American Epilepsy Society (AES) Annual Meeting 2022 in Nashville, TN.

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