Abstract Number: Esoc2026a1500 Early and Late Seizure Incidence After Acute Ischemic Stroke: Preliminary Data From Argentina

Abstract Background and aims Patients with acute ischemic stroke (AIS) with early seizures (ES; ≤7 days after stroke onset) are at increased risk of developing post-stroke epilepsy. The SeLECT score is a validated tool for stratifying this risk; however, evidence supporting the use of early antiseizure medication (ASM) to prevent late seizures (LS; 7 days after stroke onset) remains limited. We aim to describe the incidence of ES and late seizures (LS) in a cohort of first-ever AIS patients in Argentina. Methods Prospective, observational study included patients aged ≥18 years with first-ever AIS admitted to two Argentine centers between 2022 and 2024. Baseline demographic variables and SeLECT score were collected. Patients were followed for 12 months to determine the incidence of ES and LS. Those with ES and SeLECT scores ≥6 received ASM at the discretion of the treating physician. Results 78 patients were included (median age 65.5 years, IQR 59–74; 56 men, 72%). Six patients (7.7%) presented ES and 2 (2.6%) LS. All ES patients had SeLECT ≥6 and were treated with levetiracetam. Only 1/6 (16.7%) patients with ES develop LS. Among patients without ES, 1/72 (1.4%) developed LS (SeLECT 5), presenting as convulsive status epilepticus 1 year after stroke. Conclusions In this cohort, LS incidence after AIS was low-even among patients with ES and high SeLECT who received early ASM—consistent with prior reports. Our study provides one of the first prospective descriptions of post-stroke seizure incidence in Latam, emphasizing the need to validate preventive strategies tailored to region’s healthcare systems. Conflict of interest Nothing to disclose Table 1 - belongs to Background and aims Table 2 - belongs to Background and aims