Introduction: The Unmet Need in Post-Stroke Care
Post-stroke epilepsy (PSE) remains one of the most debilitating long-term complications of both ischemic and hemorrhagic strokes. While acute symptomatic seizures occur within the first week of a vascular event, the development of chronic epilepsy involves a complex biological process known as antiepileptogenesis. Currently, clinical guidelines do not recommend the prophylactic use of antiseizure medications (ASMs) to prevent epilepsy, primarily due to a lack of evidence that current drugs can alter the underlying disease course rather than merely suppressing symptoms.
Eslicarbazepine acetate (ESL), a once-daily, voltage-gated sodium channel blocker that targets the inactivated state of the channel, has shown promise in preclinical models for its potential neuroprotective and antiepileptogenic properties. The BIA-2093-213 trial represents a significant step in determining whether early intervention with ESL can modify the risk of unprovoked seizures in high-risk patients.
