Introduction: The Clinical Challenge of Poststroke Epilepsy
Ischemic stroke is not only a leading cause of long-term disability but also the most common cause of adult-onset epilepsy. Poststroke epilepsy (PSE)—defined as the occurrence of unprovoked seizures more than seven days after the index event—affects a significant subset of survivors, leading to increased morbidity, higher mortality rates, and a diminished quality of life. Despite its clinical importance, identifying which patients are at the highest risk for PSE has remained a challenge for clinicians. Previous models, such as the SeLECT and SeLECT2.0 scores, provided a foundation for risk assessment, but their performance has been variable across different populations and clinical settings. The need for a more robust, imaging-integrated, and internationally validated tool led to the development of the IsCHEMiA score.
