{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T09:59:39Z","timestamp":1790675979084,"version":"4.1.0"},"reference-count":54,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Infantile epileptic spasms syndrome (IESS) is an epileptic encephalopathy requiring rapid diagnosis and treatment to optimize neurodevelopmental outcomes. Although multiple national and regional guidelines exist, recommendations vary. We conducted a comparative scoping review of international IESS guidelines to synthesize current recommendations, evaluate trends, and examine regional differences in diagnosis and treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Published guidelines were identified through MEDLINE, Embase, and Cochrane CENTRAL, using PRISMA\u2010ScR (Preferred Reporting Items of Systematic Reviews and Meta\u2010Analyses, extension for scoping reviews) methodology and PROSPERO (Prospective Register of Systematic Reviews) registration. Unpublished institutional protocols were obtained from pediatric neurologists worldwide. Extracted variables included diagnostic evaluation, treatment recommendations, dosing, response assessment, and monitoring. Descriptive analysis compared recommendations across regions and time periods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty\u2010eight guidelines were analyzed (16 published, 12 unpublished), including 15 from high\u2010income countries (HICs) and 11 from low\u2010 and middle\u2010income countries (LMICs). Electroencephalography was recommended in nearly all guidelines (27\/28, 96%), whereas brain magnetic resonance imaging (20\/28, 71%) and genetic testing (15\/28, 54%) were less consistent. Vigabatrin was universally recommended as first\u2010line therapy for IESS\u2010associated tuberous sclerosis complex. Earlier guidelines (2004\u20132015) favored adrenocorticotropic hormone (ACTH), whereas recent guidelines (2016\u20132024) increasingly endorsed prednisolone and vigabatrin. Combination therapy emerged after 2017 (~25%). LMIC guidelines uniformly recommended prednisolone, whereas HIC guidelines more frequently endorsed ACTH, vigabatrin, and combination therapy. Treatment response was most often assessed at ~14\u2009days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>International IESS guidelines share core principles but demonstrate evolving practices and persistent global disparities. HIC and LMIC recommendation differences likely reflect variation in medication access, cost, and diagnostic resources. Harmonized international guidance may reduce disparities and improve equitable care. Further research is needed to develop standardized treatment protocols and explore novel therapeutic options to optimize outcomes for infants with IESS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epi.70329","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T13:41:01Z","timestamp":1781185261000},"page":"4600-4617","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Diagnosis and management guidelines for infantile epileptic spasms syndrome around the world: A scoping review and comparative study of international approaches"],"prefix":"10.1002","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8952-3005","authenticated-orcid":false,"given":"Gozde","family":"Erdemir","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Neurology Penn State Health Milton S. Hershey Medical Center, Penn State College of Medicine  Hershey Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chethan K.","family":"Rao","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Maryland School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5916-4678","authenticated-orcid":false,"given":"Anne Francine","family":"Pino","sequence":"additional","affiliation":[{"name":"Pennsylvania State College of Medicine  Hershey Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Briscoe","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Boston Children's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5154-8717","authenticated-orcid":false,"given":"Debopam","family":"Samanta","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Neurology University of Arkansas for Medical Sciences  Little Rock Arkansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7328-1796","authenticated-orcid":false,"given":"Jo M.","family":"Wilmshurst","sequence":"additional","affiliation":[{"name":"Department of Paediatric Neurology Red Cross War Memorial Children's Hospital, Neuroscience Institute, University of Cape Town  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonal","family":"Bhatia","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Texas Southwestern Medical Center  Dellas Texas 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Neurology Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6851-0646","authenticated-orcid":false,"given":"Robyn","family":"Whitney","sequence":"additional","affiliation":[{"name":"Department of Pediatrics McMaster University  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4567-7678","authenticated-orcid":false,"given":"Ryuki","family":"Matsuura","sequence":"additional","affiliation":[{"name":"Division of Pediatric Epilepsy Center Saitama Children's Medical Center  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karina Rosso","family":"Astorga","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Hospital Carlos van Buren  Valpara\u00edso Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keryma Acevedo","family":"Gallinato","sequence":"additional","affiliation":[{"name":"Pediatric Neurology Unit, Division of Pediatrics School of Medicine, Pontificia Universidad Cat\u00f3lica de Chile  Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pratibha","family":"Singhi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurology Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham  Faridabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aristides","family":"Hadjinicolaou","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Neurosciences University of Montreal  Montreal, Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5651-5981","authenticated-orcid":false,"given":"Gia","family":"Melikishvili","sequence":"additional","affiliation":[{"name":"Mediclub Georgia Medical Center  Tbilisi 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