Which medication is used for acute management of a generalized tonic-clonic seizure?

Which medication is used for acute management of a generalized tonic-clonic seizure?

• A. Valproate
• B. Lamotrigine
• C. Lorazepam
• D. Levetiracetam

Answer: (C)

The key idea is terminating an active generalized tonic-clonic seizure quickly. Lorazepam acts fast by enhancing GABA-A receptor–mediated inhibition, which rapidly dampens neuronal firing. When given intravenously, it stops ongoing seizures promptly and has a longer duration of effect than some other benzodiazepines, reducing the chance of immediate recurrence during the emergency. Other anticonvulsants like valproate, lamotrigine, and levetiracetam are important for longer-term control or preventative therapy, but they do not terminate an ongoing seizure as reliably or rapidly as lorazepam. Therefore, lorazepam is the go-to choice for acute management of an active generalized seizure.

The key idea is terminating an active generalized tonic-clonic seizure quickly. Lorazepam acts fast by enhancing GABA-A receptor–mediated inhibition, which rapidly dampens neuronal firing. When given intravenously, it stops ongoing seizures promptly and has a longer duration of effect than some other benzodiazepines, reducing the chance of immediate recurrence during the emergency. Other anticonvulsants like valproate, lamotrigine, and levetiracetam are important for longer-term control or preventative therapy, but they do not terminate an ongoing seizure as reliably or rapidly as lorazepam. Therefore, lorazepam is the go-to choice for acute management of an active generalized seizure.