Broad-spectrum anti-seizure medications are effective against focal and generalised seizures of any type and do not cause seizure aggravation.

We systematically searched and evaluated data about efficacy and safety of perampanel in generalised seizures.

Strong evidence supports the efficacy of perampanel in tonic–clonic seizures in idiopathic generalised epilepsy.

Observational studies suggest (with high risk of bias) effectiveness in myoclonic, absence and tonic seizures, and generalised epilepsy syndromes.

We found no evidence to suspect an association between perampanel and seizure worsening in generalised epilepsies.