Neurology Alert – September 1, 2025

Giant Cell Arteritis Has New Options for Steroid-Sparing Therapy

The SELECT-GCA Study trial of patients with giant cell arteritis found that upadacitinib at 15 mg daily combined with a 26-week glucocorticoid taper showed efficacy superior to placebo treatment with a 52-week glucocorticoid taper. The 15-mg dose of oral upadacitinib added to a shorter steroid treatment regimen was well-tolerated and appeared to be safe, as compared to placebo treatment with a longer period of steroid treatment.

EEG in Patients with Disorders of Consciousness

Abnormal background continuity, ictal-interictal continuum features, and an unreactive electroencephalogram (EEG) background were independently associated with unfavorable outcomes in the overall cohort of patients with acute brain injuries. In addition, an unreactive EEG predicted unfavorable outcomes at six months with high specificity across multiple patient subgroups. However, the sensitivity of unreactive EEG for predicting unfavorable outcomes was low.

Treatment Window for Lowering Blood Pressure in Acute ICH

Effective treatment for acute intracerebral hemorrhage (ICH) has remained elusive, with inconclusive results from surgical evacuations, as well as blood pressure management. The investigators performed a pooled analysis of four INTERACT trials that studied the effect of aggressive blood pressure lowering in patients with acute ICH. Ultra-early treatment (< 3 hours from onset) may be beneficial, but most patients are not so quickly diagnosed or treated.

Clinical and Genetic Reassessment of Patients with Presumed Hereditary Polyneuropathy

This is an observational, cross-sectional study of patients seen at a specialized neuromuscular center with a clinical diagnosis of hereditary polyneuropathy, without a previously identified genetic diagnosis. The goal of this study was to assess the combination of clinical reassessment with updated genetic testing, including whole genome sequencing. Reassessment improved the diagnostic clarification rate in these patients.

The Walk ’n Watch Trial: Stroke Recovery Through High-Intensity Walking

An intensive real-life walking protocol, started as soon as possible after acute stroke, resulted in improved overall walking endurance, mobility, balance, and quality of life.