What is the first-line treatment for absence seizures?

Ethosuximide is recognized as the first-line treatment for absence seizures, primarily due to its targeted mechanism of action. It works by inhibiting T-type calcium channels in the thalamic neurons, which play a crucial role in the generation of the abnormal electrical activity associated with absence seizures.

The efficacy of ethosuximide specifically addresses the characteristic features of absence seizures, leading to significant improvement in seizure control with a favorable side effect profile. It is often considered the treatment of choice, particularly in children who are commonly affected by absence seizures.

In cases where ethosuximide is ineffective or not tolerated, other medications such as valproic acid and lamotrigine may be considered. However, phenytoin is generally not used for absence seizures, as it can potentially worsen these types of seizures rather than control them.