{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T10:15:35Z","timestamp":1780481735374,"version":"3.54.1"},"reference-count":29,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T00:00:00Z","timestamp":1773100800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T00:00:00Z","timestamp":1773100800000},"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 Open"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the frequency, predictors, and clinical implications of diagnostic reassessment in patients previously diagnosed with childhood\u2010onset epilepsy during the transition period to adult care at a tertiary epilepsy center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study of 317 patients previously diagnosed with childhood\u2010onset epilepsy who underwent diagnostic reassessment between April 2018 and December 2023 at age 16\u2009years or older at a tertiary epilepsy center in Japan. Diagnostic revision was defined as a newly established or corrected epilepsy\/epilepsy syndrome diagnosis, identification of structural or genetic\/metabolic etiologies, or diagnosis of non\u2010epileptic conditions. Univariate and multivariate logistic regression analyses were performed to identify independent predictors of diagnostic revision.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A new or revised diagnosis was established in 60 of the 317 patients (18.9%). Independent predictors of diagnostic revision included exclusively non\u2010motor seizures (adjusted odds ratio [aOR]\u2009=\u20097.610; 95% confidence interval [CI]: 2.660\u201321.767;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and weekly or monthly seizure frequency (aOR\u2009=\u20093.370; 95% CI: 1.265\u20138.976;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.015), whereas prior visits to other epilepsy centers were strongly protective (aOR\u2009=\u20090.047; 95% CI: 0.015\u20130.146;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Sensitivity analyses yielded consistent results. Newly identified etiologies include focal cortical dysplasia, hippocampal sclerosis, and pathogenic genetic variants such as\n                      <jats:italic>CDKL5<\/jats:italic>\n                      ,\n                      <jats:italic>PCDH19<\/jats:italic>\n                      , and\n                      <jats:italic>SYNGAP1<\/jats:italic>\n                      . Diagnostic reassessment facilitated antiseizure medication withdrawal in patients with self\u2010limited epilepsy and non\u2010epileptic events.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>Nearly one in five patients previously diagnosed with childhood\u2010onset epilepsy required diagnostic revision during the transition to adult care. Non\u2010motor seizure semiology and moderate seizure frequency were the major predictors of diagnostic revision, highlighting the diagnostic uncertainty associated with subtle clinical presentations. These findings highlight that systematic reassessment, especially for individuals who have not previously undergone specialized epilepsy center evaluation, is essential for achieving an accurate diagnosis and optimizing management in adulthood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Plain Language Summary<\/jats:title>\n                    <jats:p>Many people diagnosed with epilepsy in childhood continue medical care into adulthood, but their diagnosis may need to be reviewed later in life. In this study, nearly one in five patients who had been diagnosed with childhood\u2010onset epilepsy required a change or refinement of their diagnosis when reassessed after age 16. Patients with seizures without clear physical movements and those whose seizures occurred weekly or monthly were more likely to need diagnostic review. These findings highlight the importance of reviewing the diagnosis during adolescence, especially for patients who have not previously been evaluated at specialized epilepsy centers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epi4.70248","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T09:06:17Z","timestamp":1773133577000},"page":"871-882","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic reassessment in patients previously diagnosed with childhood\u2010onset epilepsy during the transition to adult care: A retrospective cohort study in a tertiary epilepsy center"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4786-9486","authenticated-orcid":false,"given":"Tetsuhiro","family":"Fukuyama","sequence":"first","affiliation":[{"name":"Department of Pediatrics Shinshu University School of Medicine  Matsumoto Japan"},{"name":"Epilepsy Center of Shinshu University Hospital  Matsumoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1317-1699","authenticated-orcid":false,"given":"Masaru","family":"Nasuno","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Shinshu University School of Medicine  Matsumoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manami","family":"Yabe","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Shinshu University School of Medicine  Matsumoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Nishioka","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Shinshu University School of Medicine  Matsumoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yumi","family":"Hoshino","sequence":"additional","affiliation":[{"name":"Department of Neurology Shinshu University School of Medicine  Matsumoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1716-9489","authenticated-orcid":false,"given":"Takenori","family":"Natsume","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Shinshu University School of Medicine  Matsumoto Japan"},{"name":"Department of Pediatrics Nagano Red Cross Hospital  Nagano Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9667-9828","authenticated-orcid":false,"given":"Kohei","family":"Kanaya","sequence":"additional","affiliation":[{"name":"Epilepsy Center of Shinshu University Hospital  Matsumoto Japan"},{"name":"Department of Neurosurgery Shinshu University School of Medicine  Matsumoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7283-1503","authenticated-orcid":false,"given":"Kyoko","family":"Takano","sequence":"additional","affiliation":[{"name":"Center for Medical Genetics Shinshu University Hospital  Matsumoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoki","family":"Kaneko","sequence":"additional","affiliation":[{"name":"Department of Radiology Shinshu University School of Medicine  Matsumoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7654-036X","authenticated-orcid":false,"given":"Yushi","family":"Inoue","sequence":"additional","affiliation":[{"name":"National Epilepsy Center NHO Shizuoka Institute of Epilepsy and Neurological Disorders  Shizuoka 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