When do you consider long-term anti-seizure medication for patients who have an acute symptomatic seizure in the setting of a cerebrovascular event?  

The question is really which patients who suffer acute symptomatic seizures are at the highest risk of epilepsy and therefore may require long-term antiseizure medication.This recent paper from Neurology Clinical Practice by Sivaraju et al., PMID 39185097 can help shed some light on stratifying thes...

I think it really requires an individualized approach to each case. There is no hard and fast rule, and though a scoring paradigm like EPI-PASS is helpful, discontinuation of ASMs should always be a goal if seizures have not recurred outside the acute time window. I do think a follow-up EEG demonstr...