Post-stroke epilepsy is defined as seizures without a history of epilepsy before stroke, which appear within a certain period of time after stroke and exclude brain and other metabolic pathologies. According to the time point of the first epileptic seizure appearing after stroke, post-stroke epileptic seizures can be divided into early-onset epileptic seizures and late-onset epileptic seizures, and the time cut-off point for both is set at 2 weeks in China; while the International League Against Epilepsy sets it at 1 week, PSE is defined as the occurrence of 2 or more epileptic seizures at least 1 week after stroke. The pathogenesis of PSE involves the following aspects: early onset epileptic seizures are caused by local metabolic disorders in the brain and increased release of excitatory neurotransmitters in the brain secondary to ischemia and hypoxia, whereas late onset epileptic seizures are associated with gradual neuronal degeneration, necrosis and glial cell proliferation leading to structural changes in brain tissue; in addition, deposition of erythrocyte metabolites such as iron-containing heme is an important factor in secondary epilepsy after cerebral hemorrhage. important factor. Risk factors affecting post-stroke epilepsy mainly involve stroke type, stroke site and size, and stroke severity, with hemorrhagic stroke, cortical stroke, large stroke lesions, and high stroke severity increasing the risk of PSE, and early-onset seizures themselves being important risk factors for PSE. The impact of post-stroke epileptic seizures on stroke prognosis (including length of stay, disability, and mortality) is unclear, and it is generally accepted that early-onset seizures affect the prognosis of stroke patients, whereas late-onset seizures have less impact. Once post-stroke epileptic seizures occur, it is particularly important to choose the timing and treatment plan. Prophylactic use of antiepileptic drugs after stroke is not recommended. Since about 1/3 of early-onset epileptic seizures and more than 1/2 of late-onset epileptic seizures will develop into PSE, it has been suggested that the first early-onset epileptic seizures can be left untreated or treated for a short period of time, while 2 early-onset epileptic seizures and the first late-onset epileptic seizures should Consider giving antiepileptic drug treatment to prevent recurrence. Drug selection in PSE patients should consider not only the type of seizure but also the drug interactions, because this group of patients often combine multiple drugs. According to the ILAE treatment guidelines, gabapentin and lamotrigine can be the drugs of choice for elderly PSE patients with partial-onset seizures as level A evidence; levetiracetam can also be used because of the small interaction with other drugs.