Neurology Alert – May 1, 2025

Manual Maneuvers for the Treatment of Benign Positional Vertigo

Benign positional vertigo is a challenge to treat. This clinical trial from investigators in South Korea demonstrated modest efficacy in resolving posterior canal-related vertigo with a head-shaking maneuver that is easily performed in an office setting.

Can Anti-Amyloid Antibody Treatment Delay the Clinical Onset of Alzheimer’s Disease?

In this open-label extension of the dominantly inherited Alzheimer’s disease gantenerumab trial (DIAN-TU), long-term continuous amyloid clearance over eight or more years in asymptomatic carriers of autosomal dominant Alzheimer’s mutations showed potential to delay symptom onset and slow progression. Shorter duration or partial clearance did not yield measurable clinical benefit, suggesting that only sustained, near-complete amyloid removal may have disease-modifying effects.

The Effect of High-Dose Vitamin D on Clinically Isolated Syndrome and MS

This study by Thouvenot et al evaluated the effectiveness of high-dose vitamin D treatment on clinically isolated syndrome and early multiple sclerosis as monotherapy and reported a reduced incidence of new disease activity compared to the control group.

Medications for Women Aged 10 to 50 Years with Idiopathic Generalized Epilepsy

After failure of first-line anti-seizure medication, women with idiopathic generalized epilepsy may receive either substitution monotherapy or add-on therapy. There were no significant differences in effectiveness or safety between substitution monotherapy and add-on therapy in this retrospective comparative study.

Telemedicine for Managing Patients with Epilepsy

This retrospective study found telemedicine (TM) visits to be noninferior to in-person (IP) visits for key outpatient epilepsy care outcomes, including medication adjustment, surgery discussions, and avoiding emergency visits. TM was less effective for assessing the neurologic exam, and seizure freedom rates were inconclusive with respect to noninferiority. Although not a full replacement for IP care, TM remains an effective option since its future in healthcare delivery is being reassessed in the wake of the COVID-19 pandemic.