Akinetic Seizures (Drop Attacks): Sudden Loss of Muscle Tone

Akinetic seizures (astatic/drop seizures) feature abrupt loss of postural tone without impaired consciousness.

• Patient suddenly collapses (head drop, knee buckling, full fall)
• Duration: seconds
• Rapid recovery, no postictal confusion
• Often part of Lennox-Gastaut syndrome or other epileptic encephalopathies

Differential: cataplexy (emotion-triggered, conscious), syncope (prodrome, pallor), atonic seizures (same, but term "akinetic" emphasizes motor arrest).

Video-EEG confirms diagnosis; treatment includes valproate, lamotrigine, rufinamide, ketogenic diet, VNS.