Early Initiated Ambulance-delivered Levetiracetam and Headposition in Hyper-acute Stroke Trial

Intervention group - to commence IV levetiracetam 500mg as a single bolus in the ambulance, and then to continue as levetiracetam 500mg bid orally after admission to hospital in those with confirmed acute stroke for the next 14 days (at least 7 days if either dead or discharged from hospital if earlier). They will also receive standard management of acute stroke, whether the final diagnosis is ischaemic or ICH

To receive stroke management according to standard local guidelines, but to avoid prophylactic use of an anti-seizure drug.

Lie flat (0°) - in the ambulance as soon as possible until arrival at hospital.

Sit up(30-60°) - in the ambulance as soon as possible until arrival at hospital.