What is the first-line treatment for atonic or tonic seizures?

Atonic and tonic seizures, often associated with generalized epilepsy syndromes such as Lennox-Gastaut syndrome, require effective management to minimize the episodes and improve the quality of life for patients. Sodium valproate is considered the first-line treatment for these types of seizures due to its broad spectrum of efficacy against various seizure types, including both tonic and atonic seizures.

Sodium valproate works by increasing the availability of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter in the brain, which helps stabilize neuronal activity and prevent seizure formation. Its effectiveness in managing atonic and tonic seizures is well-supported by clinical guidelines and research, making it a preferred choice among healthcare professionals.

Other medications, such as levetiracetam, ethosuximide, and lacosamide, have different mechanisms and efficacy profiles, but they are not typically categorized as first-line treatments for atonic or tonic seizures. Levetiracetam is often used for various seizure types but is not the primary choice for tonic or atonic seizures. Ethosuximide is primarily effective against absence seizures, while lacosamide has a more limited indication for partial-onset seizures. Therefore, sodium valproate remains the recommended first-line treatment for addressing