# Practical Neurology

> Clinical neurology news, CME, case reports, and educational series across all neurology subspecialties.

## About

- AI guide: [/ai.md](https://practicalneurology.com/ai.md) (site identity, usage policy, FAQ)

## Sections

- [Diseases & Diagnoses](https://practicalneurology.com/diseases-diagnoses.md): Content organized by neurology subspecialty
- [CME](https://practicalneurology.com/cme.md): Accredited continuing medical education activities
- [Case Reports](https://practicalneurology.com/case-reports.md): Real clinical cases and discussions
- [Archives](https://practicalneurology.com/archives.md): Full content archive

## Recent articles

- [FDA Grants Breakthrough Device Designation to Aurenar's Investigational V-Link System for Cerebral Vasospasm After Aneurysmal Subarachnoid Hemorrhage](https://practicalneurology.com/news/fda-grants-breakthrough-device-designation-to-aurenars-investigational-v-link-system-for-cerebral-vasospasm-after-aneurysmal-subarachnoid-hemorrhage/2487686/): KEY TAKEAWAYS The FDA granted Breakthrough Device Designation to the investigational V-Link system for reducing cerebral vasospasm in adults with aneurysmal subarachnoid hemorrhage receiving ICU care. The designation is intended to facilitate FDA interactions and accelerate devel
- [Personalized Blood Pressure Targets After Stroke Thrombectomy Improved 90-Day Recovery in HOPE Trial](https://practicalneurology.com/news/personalized-blood-pressure-targets-after-stroke-thrombectomy-improved-90-day-recovery-in-hope-trial/2487669/): KEY TAKEAWAYS The personalized strategy reduced hemorrhagic transformation without increasing symptomatic intracranial hemorrhage or mortality. Investigators state the findings support further study but should be interpreted cautiously because the trial ended early. Adults with a
- [FDA Sets September Target Action Date for Pixclara PET Imaging Agent in Glioma](https://practicalneurology.com/news/fda-sets-september-target-action-date-for-pixclara-pet-imaging-agent-in-glioma/2487662/): KEY TAKEAWAYS The FDA accepted Telix’s resubmitted New Drug Application for Pixclara, an investigational PET imaging agent for glioma. The agency assigned a Prescription Drug User Fee Act target action date of September 11, 2026. Pixclara is being evaluated for characterization o
- [Translingual Neuromodulation Device Receives FDA 510(k) Clearance for Stroke-Related Gait Deficit](https://practicalneurology.com/news/translingual-neuromodulation-device-receives-fda-510k-clearance-for-stroke-related-gait-deficit/2487643/): KEY TAKEAWAYS The FDA granted 510(k) clearance for the PoNS System to treat dynamic gait deficit due to chronic stroke symptoms. The noninvasive neuromodulation device, which is applied to the tongue, is intended for use with a supervised therapeutic exercise program in patients 
- [Xeomin Label Expanded for Pediatric Upper Limb Spasticity Associated With Cerebral Palsy](https://practicalneurology.com/news/xeomin-label-expanded-for-pediatric-upper-limb-spasticity-associated-with-cerebral-palsy/2487631/): KEY TAKEAWAYS The FDA approved a label update expanding Xeomin’s indication to children and adolescents with cerebral palsy. The updated label applies to patients aged 2 years and older with upper limb spasticity associated with cerebral palsy. Cerebral palsy–related spasticity c
- [Two-Step Blood Test Improved Alzheimer Disease Diagnosis and Predicted Cognitive Decline](https://practicalneurology.com/news/two-step-blood-test-improved-alzheimer-disease-diagnosis-and-predicted-cognitive-decline/2487617/): KEY TAKEAWAYS Sequential plasma testing with %p-tau217 and eMTBR-tau243 improved identification of symptomatic Alzheimer disease. Positive eMTBR-tau243 results were associated with greater tau pathology and faster cognitive decline. The findings support a blood-based approach to 
- [C1q Inhibitor Tanruprubart Shows Functional Benefit in Guillain-Barré Syndrome](https://practicalneurology.com/news/c1q-inhibitor-tanruprubart-shows-functional-benefit-in-guillain-barre-syndrome/2487601/): KEY TAKEAWAYS Tanruprubart improved functional recovery in Guillain-Barré syndrome, meeting the primary end point of a phase 3 trial. Earlier treatment after symptom onset and lower baseline neurofilament light levels were associated with greater benefit. Tanruprubart was general
- [PrimeC Demonstrates Positive Results on End Points in ALS Trial](https://practicalneurology.com/news/primec-shows-safety-exploratory-clinical-signals-in-phase-2b-als-trial/2487589/): KEY TAKEAWAYS PrimeC was safe and generally well tolerated over 18 months in the phase 2b PARADIGM trial. The trial was not powered for efficacy, but exploratory findings showed separation in ALSFRS-R scores and ALS complication–free survival, favoring continuous PrimeC treatment
- [FDA Grants Breakthrough Therapy Designation for Investigational Treatment for Vanishing White Matter Disease](https://practicalneurology.com/news/fda-grants-breakthrough-therapy-designation-for-investigational-treatment-for-vanishing-white-matter-disease/2487575/): KEY TAKEAWAYS The FDA granted Breakthrough Therapy designation to investigational fosigotifator for vanishing white matter disease. Fosigotifator is an eIF2B activator being evaluated in a phase 1b/2 trial that includes adult, pediatric, and infant participants with vanishing whi
- [AASM Launches Training Program for Sleep Medicine Coding, Billing, and Compliance](https://practicalneurology.com/news/aasm-launches-training-program-for-sleep-medicine-coding-billing-and-compliance/2487544/): KEY TAKEAWAYS The American Academy of Sleep Medicine has launched Sleep-CODE, a 14-module educational program focused on coding, billing, reimbursement, compliance, and operational management in sleep medicine. The program is designed for multidisciplinary sleep teams, including 
- [In-Hospital Stroke Still Linked to Worse Outcomes Despite Increased Use of Mechanical Thrombectomy](https://practicalneurology.com/news/in-hospital-stroke-remains-linked-to-worse-outcomes-despite-increased-use-of-mechanical-thrombectomy/2487538/): KEY TAKEAWAYS In-hospital stroke was associated with higher mortality and worse functional outcomes than community-onset stroke. Mechanical thrombectomy use increased significantly between 2016 and 2023 in both groups. Recognition-to-CT time was longer for in-hospital stroke than
- [Bioxtreme Launches Dextreme 2.0 Robotic Rehabilitation System for Upper Extremity Recovery](https://practicalneurology.com/news/bioxtreme-launches-dextreme-20-robotic-rehabilitation-system-for-upper-extremity-recovery/2487528/): KEY TAKEAWAYS Bioxtreme launched Dextreme 2.0, a robotic rehabilitation platform intended to support upper extremity recovery after stroke and other neurologic injuries. The system uses error augmentation, adaptive AI, and immersive therapy activities to support motor learning an
- [Oveporexton Improved Function, Cognition, and Sleep Outcomes in Narcolepsy Type 1](https://practicalneurology.com/news/oveporexton-improved-function-cognition-and-sleep-outcomes-in-narcolepsy-type-1/2487512/): KEY TAKEAWAYS Oveporexton treatment improved daily functioning at week 12 compared with placebo in 2 pivotal phase 3 studies of people with narcolepsy type 1. Secondary and exploratory analyses showed improvements in cognitive symptoms, disturbed nighttime sleep, hallucinations, 
- [Investigational Antiseizure Medication Reduced Seizure Frequency in Phase 3 Focal Epilepsy Trial](https://practicalneurology.com/news/investigational-antiseizure-medication-reduced-seizure-frequency-in-phase-3-focal-epilepsy-trial/2487481/): KEY TAKEAWAYS Treatment with azetukalner was associated with greater reductions in monthly seizure frequency than placebo in the phase 3 X-TOLE2 trial. The 25-mg dose was associated with a 53.2% median reduction in monthly seizure frequency during the 12-week double-blind treatme
- [Phase 4 Parkinson Disease Study Shows Increase in Good “On” Time After Switching to Crexont](https://practicalneurology.com/news/crexont-increased-good-on-time-in-phase-4-parkinson-disease-study/2487472/): KEY TAKEAWAYS Interim phase 4 ELEVATE-PD data showed increases in daily good "on" time and reductions in "off" time after participants switched to Crexont. Benefits were reported across prior levodopa-based treatment groups, including immediate-release carbidopa/levodopa, immedia
- [American Epilepsy Society Releases Behavioral Health Screening Toolkit for Epilepsy Care](https://practicalneurology.com/news/american-epilepsy-society-releases-behavioral-health-screening-toolkit-for-epilepsy-care/2487446/): Key Takeaways The American Epilepsy Society has launched a behavioral health screening toolkit for use in epilepsy care settings. The toolkit includes screening resources for depression, anxiety, suicidality, behavioral concerns, and quality-of-life domains. AES notes that screen
- [Symbravo Outperformed Gepants Across Multiple Acute Migraine End Points in Network Meta-Analysis](https://practicalneurology.com/news/symbravo-outperformed-gepants-across-multiple-acute-migraine-end-points-in-network-meta-analysis/2487443/): KEY TAKEAWAYS Symbravo was associated with higher odds of 2-hour pain freedom and 2- to 24-hour sustained pain freedom compared with rimegepant, ubrogepant, and zavegepant. The network meta-analysis included the phase 3 MOMENTUM trial and 7 placebo-controlled phase 3 trials of cu
- [Long-Term Safety Profile of Qulipta Evaluated in 3-Year Migraine Prevention Extension Study](https://practicalneurology.com/news/qulipta-maintains-long-term-safety-profile-in-3-year-migraine-prevention-extension-study/2487423/): KEY TAKEAWAYS Qulipta (atogepant) was generally safe and well tolerated through 156 weeks in people with chronic or episodic migraine. No new safety signals were identified during the 3-year extension study. Exploratory efficacy outcomes, including reductions in monthly migraine 
- [Bocunebart Reduced Monthly Migraine Days in Phase 2b PROCEED Trial](https://practicalneurology.com/news/bocunebart-reduces-monthly-migraine-days-in-phase-2b-proceed-trial/2487409/): KEY TAKEAWAYS The intravenous portion of the phase 2b PROCEED trial met its primary efficacy end point, with bocunebart associated with a statistically significant reduction in monthly migraine days compared with placebo over weeks 1 to 12. Pooled phase 2 analyses in participants
- [Salanersen Receives FDA Breakthrough Therapy Designation for Spinal Muscular Atrophy](https://practicalneurology.com/news/salanersen-receives-fda-breakthrough-therapy-designation-for-spinal-muscular-atrophy/2487388/): Key Takeaways The FDA granted Breakthrough Therapy designation to salanersen for spinal muscular atrophy. The decision was based on phase 1b exploratory data in children with SMA who had previously received gene therapy and had suboptimal clinical status. Biogen is evaluating onc

## Recent segments

- [Bill Nye on Ataxia, Family Risk, and the Search for Answers](https://practicalneurology.com/diseases-diagnoses/movement-disorders/bill-nye-on-ataxia-family-risk-and-the-search-for-answers/60992/): In this episode, Bill Nye—science communicator, television presenter, and ataxia advocate—shares his experience growing up in a family affected by ataxia, discusses the challenges of individuals living with rare neurologic diseases, and reflects on how he has been impacted by the
- [Advancing MOGAD Care](https://practicalneurology.com/diseases-diagnoses/ms-immune-disorders/advancing-mogad-care/60954/): What do the latest METEOROID trial results mean for neurologists treating myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD)? Michael Levy, MD, Massachusetts General Hospital, Boston, MA, discusses relapse prevention, diagnostic challenges, and the future of 
- [Early Alzheimer Disease Detection through a Davos Initiative: Building Communities of Practice for Sustainable Change](https://practicalneurology.com/diseases-diagnoses/alzheimer-disease-dementias/early-alzheimer-disease-detection-through-a-davos-initiative-building-communities-of-practice-for-sustainable-change/60859/): In this episode, Elyse Perweiler, RN, MPP, Professor, Rowan–Virtua School of Osteopathic Medicine, Stratford, NJ, and Tim MacLeod, PhD, Executive Director, Healthcare System Preparedness Program, Davos Alzheimer's Collaborative, Toronto, Ontario, Canada, examine how peer learning
- [Early Alzheimer Disease Detection through a Davos Alzheimer's Collaborative Initiative: Lessons from Real-World Implementation](https://practicalneurology.com/diseases-diagnoses/alzheimer-disease-dementias/part-ii-early-alzheimer-disease-detection-through-a-davos-alzheimers-collaborative-initiative-lessons-from-real-world-implementation/60628/): This episode explores the real-world implementation of the Davos Alzheimer’s Collaborative Healthcare System Preparedness (DAC-SP) US Early Detection Program at Virtua Health, examining outcomes in identifying cognitive impairment, streamlining referrals, and supporting efficient
- [About the Artist: Hidden in Color, by Isabella Sammut](https://practicalneurology.com/diseases-diagnoses/headache-pain/about-the-artist-hidden-in-color-by-isabella-sammut/57272/): Isabella Sammut, a 17-year-old high school senior, uses art to raise awareness for headache disorders and advocate for more research and better treatments.
- [Navigating Medicolegal Needs in Headache Medicine: Section 504, FMLA, and SSDI/SSI](https://practicalneurology.com/diseases-diagnoses/headache-pain/navigating-medicolegal-needs-in-headache-medicine-section-504-fmla-and-ssdissi/57271/): Headache specialists play a key role in helping patients secure the accommodations and benefits to which they are entitled; accurate, thorough evaluation and documentation are the foundation of successful claims under applicable legal frameworks.
- [Functional Neurologic Disorder in Headache Medicine: Diagnosis, Management, and Multidisciplinary Care](https://practicalneurology.com/diseases-diagnoses/headache-pain/functional-neurologic-disorder-in-headache-medicine/57270/): Functional neurologic disorder and migraine frequently overlap, share common triggers, and can exacerbate one another.
- [Cluster Headache Advocacy: The Role and Impact of Patient-Led Organizations](https://practicalneurology.com/diseases-diagnoses/headache-pain/cluster-headache-advocacy-the-role-and-impact-of-patient-led-organizations/57269/): The advocacy efforts of patient-led organizations have improved diagnosis, treatment, and support for people with cluster headache disorders.
- [Effective Communication Strategies for Managing Migraine Care Challenges](https://practicalneurology.com/diseases-diagnoses/headache-pain/effective-communication-strategies-for-managing-migraine-care-challenges/57268/): Effective communication is central to the patient–clinician relationship, facilitating timely, compassionate care, avoiding the perpetuation of stigma, and reducing the social impact of headache disorders.
- [Breaking the Stigma Around Headache: The Hidden Barrier to Effective Headache Care](https://practicalneurology.com/diseases-diagnoses/headache-pain/breaking-the-stigma-around-headache-the-hidden-barrier-to-effective-headache-care/57266/): Migraine stigma has emerged as an important social factor that may affect patient and provider behavior and exacerbate migraine burden.