When do you consider long-term anti-seizure medication for patients who have an acute symptomatic seizure in the setting of a cerebrovascular event?
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What is your preferred method for evaluating persistent epileptiform discharges during post-hospital follow-up after an acute symptomatic seizure?
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2 Answers
Mednet MemberInvited Expert
Neurology · University of Rochester Medical Center
Answered on · Updated on
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...
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Mednet MemberInvited Expert
Neurology · Mayo Clinic Florida
Answered on
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...
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