SV2A and pulmonary hypertension, primary, 1: Critical analysis reveals divergent pharmacotherapeutic profiles: while meta-analyses indicate comparable seizure control among LEV, VPA, and phenytoin (PHT), PHT exhibits significantly higher neurotoxicity, whereas LEV/VPA demonstrate superior target specificity—LEV modulates SV2A-mediated synaptic vesicle cycling without cytochrome P450 induction, and VPA promotes histone deacetylase-dependent neuroprotection.