The neurological examination is most likely to be abnormal in patients with which condition?

In the context of neurological examinations, Lennox-Gastaut syndrome is characterized by a combination of multiple seizure types, intellectual disability, and specific EEG abnormalities. Patients with this syndrome often exhibit cognitive impairment and other neurological deficits due to the severity and complexity of their condition, which can make neurological examinations reveal significant abnormalities.

The other conditions listed typically do not present with such pronounced neurological deficits. For example, Rolandic epilepsy is often considered a benign focal epilepsy of childhood and may not lead to any neurological findings outside of the seizure events. Juvenile myoclonic epilepsy, while it can have some associated cognitive or behavioral issues, usually does not produce a significant neurological examination abnormality in the interictal period. Absence seizures are often transient and might not show any neurological deficits during an examination when the person is not having a seizure.

Thus, Lennox-Gastaut syndrome stands out due to its impact on cognitive function and the associated neurological findings, making it the condition most likely to show abnormalities during a neurological examination.