Neurology Topics
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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.
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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.
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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.
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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.
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Clinical Consequences of Alzheimer’s and Lewy Body Co-Pathologies
This large study of patients with cognitive impairment-assessed cerebrospinal fluid biomarkers, positron emission tomography imaging, and cognitive tests showed that those with evidence of both Alzheimer’s and Lewy body pathologies had greater cognitive dysfunction and faster progression than those with either pathology alone.
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Clinical Consequences of Alzheimer’s and Lewy Body Co-Pathologies
This large study of patients with cognitive impairment-assessed cerebrospinal fluid biomarkers, positron emission tomography imaging, and cognitive tests showed that those with evidence of both Alzheimer’s and Lewy body pathologies had greater cognitive dysfunction and faster progression than those with either pathology alone.
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Long-Term Efficacy of Ocrelizumab as First-Line Treatment for Relapsing-Remitting Multiple Sclerosis
Nine-year follow-up data from open-label extension of the Phase III clinical trials of ocrelizumab show that, although the efficacy of ocrelizumab was maintained throughout the duration of the study, patients who were treated with ocrelizumab from the beginning of the Phase III trials did better than the patients who were on subcutaneous (SC) interferon β-1a initially and were switched to ocrelizumab at the onset of the open-label extension period.
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Small Fiber Neuropathy in Post-COVID Patients with Chronic Fatigue Syndrome
This study examines small fiber neuropathy (SFN) in post-COVID patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). While ME/CFS patients reported more SFN symptoms, objective testing showed limited diagnostic value beyond heat/cold detection differences.
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Should Thrombolytic Drugs Be Added to Mechanical Thrombectomy in Acute Stroke?
Two recent trials from China studied the effect of post-thrombectomy, intra-arterial thrombolysis on neurological outcomes. One study used tenecteplase and the other used urokinase. Both studies showed a trend toward improvement that was not statistically significant, and there was an increase in brain hemorrhage. The benefit of adjunctive thrombolysis with mechanical thrombectomy is uncertain and requires more study.
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Treating Hereditary TTR Amyloid Polyneuropathy with Patisiran
A five-year study on patisiran for hereditary transthyretin (TTR) amyloid polyneuropathy found that 65% of patients had stable or improved neuropathy, with better outcomes linked to early treatment. Despite efficacy, 19.4% of patients died. The study underscores the importance of early diagnosis and intervention in managing this progressive disease.