{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:39:04Z","timestamp":1786649944925,"version":"build-2736575974"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>There have been a few reports of patients who developed Lennox\u2013Gastaut syndrome (LGS) in the second decades of their life.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>The aim of this study was to investigate electroclinical presentation in patients with late-onset LGS. In addition, we evaluated structural abnormalities of the brain, which may give some clue about the common pathogenic pathway in LGS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>We enrolled the patients with late-onset LGS. We collected electroclinical characteristics of the patients and evaluated structural abnormalities using voxel-based morphometry (VBM) and tract-based spatial statistics (TBSS) analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The three subjects were diagnosed with late-onset LGS. The patients have no mental retardation and normal background activities on electroencephalography (EEG), and they had generalized paroxysmal fast activities on EEG, especially during sleep. The TBSS analysis revealed that fractional anisotropy values in the patients were significantly reduced in the white matter of brainstem compared with normal controls. However, VBM analysis did not show any significant difference between the patients and normal controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Patients with late-onset LGS have different clinical and EEG characteristics from those with early-onset LGS. In addition, we demonstrated that brainstem dysfunction might contribute to the pathogenesis of late-onset LGS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/0972-2327.194462","type":"journal-article","created":{"date-parts":[[2016,11,21]],"date-time":"2016-11-21T07:27:21Z","timestamp":1479713241000},"page":"518-522","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["Brainstem dysfunction in patients with late-onset Lennox\u2013Gastaut syndrome"],"prefix":"10.4103","volume":"19","author":[{"given":"Kang Min","family":"Park","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun Jung","family":"Hur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung Eun","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20-20260108","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1111\/epi.12567","article-title":"Lennox-Gastaut syndrome: A consensus approach to differential diagnosis","volume":"55","author":"Bourgeois","year":"2014","journal-title":"Epilepsia"},{"key":"R2-20-20260108","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.eplepsyres.2014.11.004","article-title":"Long-term prognosis of patients with Lennox - Gastaut syndrome in recent decades","volume":"110","author":"Kim","year":"2015","journal-title":"Epilepsy Res"},{"key":"R3-20-20260108","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1016\/j.seizure.2011.08.001","article-title":"An atypical case of Lennox-Gastaut syndrome not associated with mental retardation: A nosological issue","volume":"20","author":"Shyu","year":"2011","journal-title":"Seizure"},{"key":"R4-20-20260108","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1177\/155005949402500406","article-title":"Lennox-Gastaut syndrome in the elderly?","volume":"25","author":"Benbadis","year":"1994","journal-title":"Clin Electroencephalogr"},{"key":"R5-20-20260108","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/j.1528-1167.2011.03177.x","article-title":"Definition and natural history of Lennox-Gastaut syndrome","volume":"52","author":"Camfield","year":"2011","journal-title":"Epilepsia"},{"key":"R6-20-20260108","doi-asserted-by":"crossref","first-page":"1238","DOI":"10.1006\/nimg.2001.0961","article-title":"Why voxel-based morphometry should be used","volume":"14","author":"Ashburner","year":"2001","journal-title":"Neuroimage"},{"key":"R7-20-20260108","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1016\/S0006-3495(94)80775-1","article-title":"MR diffusion tensor spectroscopy and imaging","volume":"66","author":"Basser","year":"1994","journal-title":"Biophys J"},{"key":"R8-20-20260108","doi-asserted-by":"crossref","first-page":"1487","DOI":"10.1016\/j.neuroimage.2006.02.024","article-title":"Tract-based spatial statistics: Voxelwise analysis of multi-subject diffusion data","volume":"31","author":"Smith","year":"2006","journal-title":"Neuroimage"},{"key":"R9-20-20260108","doi-asserted-by":"crossref","first-page":"225","DOI":"10.3389\/fneur.2014.00225","article-title":"Conceptualizing lennox-gastaut syndrome as a secondary network epilepsy","volume":"5","author":"Archer","year":"2014","journal-title":"Front Neurol"},{"key":"R10-20-20260108","doi-asserted-by":"crossref","first-page":"S132","DOI":"10.1016\/j.eplepsyres.2005.11.024","article-title":"Diagnostic issues and treatment of cryptogenic or symptomatic generalized epilepsies","volume":"70","author":"Ohtsuka","year":"2006","journal-title":"Epilepsy Res"},{"key":"R11-20-20260108","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/j.eplepsyres.2010.01.012","article-title":"Lennox-Gastaut syndrome in adulthood: Clinical and EEG features","volume":"89","author":"Ferlazzo","year":"2010","journal-title":"Epilepsy Res"},{"key":"R12-20-20260108","doi-asserted-by":"crossref","first-page":"S15","DOI":"10.1684\/epd.2011.0409","article-title":"Evolution and management of Lennox-Gastaut syndrome through adolescence and into adulthood: Are seizures always the primary issue?","volume":"13","author":"Kerr","year":"2011","journal-title":"Epileptic Disord"},{"key":"R13-20-20260108","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1212\/WNL.27.8.746","article-title":"Slow spike-wave activity in EEG and associated clinical features: Often called \u201cLennox\u201d or \u201cLennox-Gastaut\u201d syndrome","volume":"27","author":"Markand","year":"1977","journal-title":"Neurology"},{"key":"R14-20-20260108","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1093\/brain\/96.2.289","article-title":"Generalized sharp and slow wave complexes. 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