Which medication is first-line for myoclonic seizures?

Sodium valproate is considered the first-line medication for myoclonic seizures due to its broad-spectrum antiepileptic properties. Myoclonic seizures are characterized by sudden, brief jerks or twitches of the muscles, and they can occur in various forms of epilepsy. Valproate works by increasing the availability of gamma-aminobutyric acid (GABA), the primary inhibitory neurotransmitter in the brain, which helps to reduce neuronal excitability and ultimately decrease seizure activity.

In addition to its efficacy for myoclonic seizures, sodium valproate is effective for various seizure types, including generalized tonic-clonic seizures and absence seizures, making it a versatile option in seizure management. This comprehensive action allows for better control of the seizures, especially in patients who may have multiple seizure types.

While other medications listed may have some use in seizure management, they are not considered first-line treatments specifically for myoclonic seizures. Carbamazepine is primarily used for focal seizures and can even exacerbate myoclonic seizures. Pregabalin is more commonly used for neuropathic pain and has limited evidence supporting its use for myoclonic seizures. Levetiracetam is sometimes used in certain contexts but is generally not the first choice compared