{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T14:53:57Z","timestamp":1791298437047,"version":"4.1.0"},"reference-count":76,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"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"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Lennox\u2013Gastaut syndrome (LGS) is a developmental and epileptic encephalopathy typically diagnosed in childhood. The 2022 International League Against Epilepsy (ILAE) criteria provide a diagnostic framework built on pediatric data, but their applicability in adulthood is challenged by disease evolution, treatment effects, and missing pediatric records. This scoping review aimed to identify adult LGS features and to evaluate the adaptability of current criteria in adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a systematic search on MEDLINE (PubMed) following the Preferred Reporting Items for Systematic reviews and Meta\u2010Analyses extension for Scoping Reviews (PRISMA\u2010ScR) guidelines. Studies involving individuals 16\u2009years of age and older with LGS or suspected LGS were included. Data were extracted on seizure semiology, electroencephalography (EEG) patterns, comorbidities, and etiological factors across the lifespan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Forty\u2010five sources (78% case reports\/series) encompassing 421 patients were included, with substantial heterogeneity in reporting. The analysis suggests a longitudinal attenuation or under\u2010documentation of several classical LGS features: studies with fulfillment of the ILAE seizure\u2010type criteria decreased from 73% in childhood to 41% in adulthood; tonic seizures often persisted (frequently during sleep), whereas atonic and atypical absence seizures significantly declined. The mandatory EEG hallmarks (generalized paroxysmal fast activity and slow spike\u2010and\u2010wave complexes) were documented in less than half of adult patients, possibly due to the reduced frequency of sleep EEG monitoring. Comorbidities were reported inconsistently, representing a major knowledge gap, as sleep and behavioral disorders may further mask diagnostic markers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>Given the heterogeneity and predominantly low\u2010level evidence of the included literature, these findings warrant cautious interpretation; nonetheless, strict adherence to pediatric\u2010centric criteria in adults may plausibly contribute to underdiagnosis or false negatives. Transitioning from a \u201csnapshot\u201d to a \u201clongitudinal\u201d diagnostic mindset is essential. Clinicians should prioritize life\u2010spanning anamnesis and recognize that the clinical and EEG core criteria of LGS may evolve or diminish over time. Age\u2010adapted diagnostic frameworks are needed to ensure that adult patients receive appropriate diagnosis and therapeutic pathways.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epi.70489","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T14:35:18Z","timestamp":1791297318000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnosing Lennox\u2013Gastaut syndrome in adulthood: A scoping review of diagnostic challenges and age\u2010related electroclinical evolution"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2845-1332","authenticated-orcid":false,"given":"Claudio","family":"Liguori","sequence":"first","affiliation":[{"name":"Department of Systems Medicine University of Rome Tor Vergata  Rome Italy"},{"name":"Neurology Unit University Hospital of Rome Tor Vergata  Rome Italy"},{"name":"IRCCS Neuromed  Pozzilli Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3405-2111","authenticated-orcid":false,"given":"Sara","family":"Casciato","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Neurology Unit S. Camillo\u2010Forlanini Hospital  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3906-555X","authenticated-orcid":false,"given":"Emanuele","family":"Cerulli Irelli","sequence":"additional","affiliation":[{"name":"Department of Human Neurosciences Sapienza University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3311-2765","authenticated-orcid":false,"given":"Marco","family":"Perulli","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario A. Gemelli IRCCS  Rome Italy"},{"name":"Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8458-8635","authenticated-orcid":false,"given":"Fabio","family":"Perversi","sequence":"additional","affiliation":[{"name":"Freelance Medical Writer  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8120-0287","authenticated-orcid":false,"given":"Nicola","family":"Specchio","sequence":"additional","affiliation":[{"name":"Neurology, Epilepsy and Movement Disorders Unit Bambino Ges\u00f9 Children's Hospital, IRCCS, Full Member of European Reference Network on Rare and Complex Epilepsies, EpiCARE  Rome Italy"},{"name":"University Hospitals KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"key":"e_1_2_18_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.17241"},{"key":"e_1_2_18_3_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000007775"},{"key":"e_1_2_18_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10072\u2010017\u20103188\u2010y"},{"key":"e_1_2_18_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.12567"},{"key":"e_1_2_18_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/epi4.12894"},{"key":"e_1_2_18_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528\u20101167.1966.tb06263.x"},{"key":"e_1_2_18_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.17866"},{"key":"e_1_2_18_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474\u20104422(08)70292\u20108"},{"key":"e_1_2_18_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2012.08.003"},{"key":"e_1_2_18_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528\u20101167.2011.03177.x"},{"key":"e_1_2_18_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2011.08.001"},{"key":"e_1_2_18_13_1","doi-asserted-by":"publisher","DOI":"10.1684\/epd.2011.0409"},{"key":"e_1_2_18_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2020.107146"},{"key":"e_1_2_18_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12874\u2010018\u20100611\u2010x"},{"key":"e_1_2_18_16_1","doi-asserted-by":"publisher","DOI":"10.7326\/M18\u20100850"},{"key":"e_1_2_18_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.13692"},{"key":"e_1_2_18_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.braindev.2023.07.004"},{"key":"e_1_2_18_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2015.10.009"},{"key":"e_1_2_18_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/155005949402500406"},{"key":"e_1_2_18_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.16394"},{"key":"e_1_2_18_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528\u20101157.1981.tb04339.x"},{"key":"e_1_2_18_23_1","doi-asserted-by":"publisher","DOI":"10.1080\/13554794.2017.1380202"},{"key":"e_1_2_18_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1059\u20101311(05)80114\u20101"},{"key":"e_1_2_18_25_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000141854.58301.4c"},{"key":"e_1_2_18_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpt.13082"},{"key":"e_1_2_18_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/WNP.0000000000000974"},{"key":"e_1_2_18_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejmg.2017.06.002"},{"key":"e_1_2_18_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebr.2022.100546"},{"key":"e_1_2_18_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2010.09.024"},{"key":"e_1_2_18_31_1","doi-asserted-by":"publisher","DOI":"10.1684\/epd.2007.0114"},{"key":"e_1_2_18_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2010.01.012"},{"key":"e_1_2_18_32_2","doi-asserted-by":"crossref","unstructured":"Erratum in: Epilepsy Res. 2010 Aug;90(3):313. 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