Lennox-Gastaut syndrome (LGS) is a severe pediatric epilepsy syndrome 
characterized by mixed seizures, cognitive decline, and generalized slow (<3 Hz) 
spike wave discharges on electroencephalography. Atonic seizures result in 
dangerous drop attacks with risks of injury and impairment of the quality of 
life. The seizures are frequently resistant to multiple antiepileptic (AED) 
drugs. Newer AEDs, such as rufinamide, are now available. When multiple AED 
trials fail, non-pharmacological treatments such as the ketogenic diet, vagus 
nerve stimulation, and epilepsy surgery, should be considered. The aim of this 
review is to present an updated outline of LGS and the available treatments. 
Although the prognosis for complete seizure control remains poor, the addition 
of newer therapies provides an improved hope for some of these patients and 
their families. Further long term randomized controlled trials are required to 
compare different therapeutic interventions in terms of efficacy and 
tolerability.