The Neurology Minute® podcast delivers a brief daily summary of what you need to know in the field of neurology, the latest science focused on the brain, and timely topics explored by leading neurologists and neuroscientists. From the American Academy of Neurology and hosted by Stacey Clardy, MD, PhD, FAAN, with contributions by experts from the Neurology® journals, Neurology Today®, Continuum®, and more.
Negative myoclonus is a brief loss of tonic muscle activity rather than an added jerk or tremor. Recognising asterixis, dropped objects, writing difficulty, head nodding or falls helps direct assessment towards epileptic cortical events, metabolic disturbance, medicine effects or structural neurological disease.
A promising biological rationale and numerical treatment signal do not overcome a trial that misses its primary endpoint. Troriluzole for spinocerebellar ataxia illustrates how slower-than-expected placebo progression, externally controlled follow-up data and residual bias can leave clinicians counselling patients honestly about benefit and regulatory uncertainty.
An open-label phase followed by randomised withdrawal helps test whether improvement in neurogenic orthostatic hypotension depends on continued treatment. Symptom worsening after ampreloxetine withdrawal in the pre-planned multiple system atrophy subgroup supports a mechanism-based signal, while still requiring cautious interpretation alongside standing blood pressure and functional impact.
Identical levodopa doses do not necessarily produce identical exposure. In a small prospective cohort, women had higher total exposure and peak concentrations, with more wearing off and dyskinesia; the finding supports careful review of response timing and motor complications without establishing fixed sex-based dosing rules.
A positive depression or anxiety screen in epilepsy starts a clinical conversation rather than completing the assessment. Direct symptom review, anti-seizure medication review, safe antidepressant selection, immediate escalation of active suicidality and psychiatry referral after two unsuccessful selective serotonin reuptake inhibitor or serotonin–noradrenaline reuptake inhibitor trials define the management pathway.
Neurology and critical-appraisal teams get a focused update on fenebrutinib in early relapsing multiple sclerosis. The FENhance trials link substantial reductions in relapse rate and MRI lesion activity with less definitive individual disability outcomes, while mortality imbalance, infection-related serious events and liver enzyme elevation remain important safety considerations.
Neurology and psychiatry clinicians get a brief screening framework for anxiety and depression in epilepsy. GAD-2, PHQ-2 and the epilepsy-specific NDDIE can support assessment at diagnosis, during treatment changes and throughout follow-up, particularly when mood effects are not volunteered.
Neurology and critical-appraisal readers get a trial update on oral fenebrutinib for primary progressive multiple sclerosis. Non-inferiority to ocrelizumab, possible benefit in non-relapsing progression and the convenience of oral treatment are balanced against liver-enzyme abnormalities, biochemical Hy’s law signals and a mortality imbalance.
Neurology clinicians and educators get a concise reminder that functional neurological disorder is clinically diverse. Assessment, explanation, treatment priorities and follow-up should be tailored to the individual rather than imposed through a single pathway, while growing research activity offers cautious grounds for optimism.
Neurology and psychiatry teams get a trauma-informed migraine update. Military sexual trauma may affect symptom burden, engagement and healthcare use, supporting sensitive enquiry and integrated psychological or psychiatric input alongside standard migraine treatment.
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