Galovic et al reported the SeLECT score for predicting late seizures in a patient who has had an ischemic stroke. This can help to identify a patient who may benefit from more aggressive management. The authors are from multiple institutions in Europe and Canada.
Patient selection: ischemic stroke
Outcome: seizures > 7 days after the ischemic stroke (overall risk 4% at 1 year, 8% at 5 years)
Parameters:
(Se) severity of stroke based on NIHSS score
(L) large-artery atherosclerosis
(E) early seizures (onset <= 7 days)
(C) cortical involvement
(T) territory of middle cerebral artery (MCA)
Parameter
Finding
Points
severity
NIHSS 0 to 3
0
NIHSS 4 to 10
1
NIHSS >= 11
2
large artery atherosclerosis
no
0
yes
1
early seizures
no
0
yes
3
cortical involvement
no
0
yes
2
territory of MCA
no
0
yes
1
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 9
• The higher the score the greater the risk of seizures.
Score
Seizures after 1 Year
Seizures after 5 Years
0
0.7%
1.3%
1
1%
2%
2
2%
4%
3
4%
6%
4
6%
11%
5
11%
18%
6
18%
29%
7
28%
45%
8
44%
65%
9
63%
83%
Performance:
• Finsterer outlined concerns in an editorial about the performance of the score.
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