Neurology Minute

Dr. Alex Menze and Dr. Divyanshu Dubey discuss the clinical insights into autoimmune nodopathies, particularly focusing on CASPR1 and CASPR1/CNTN1-complex-IgG. 
Show citation: 
Paramasivan NK, Basal E, LaFrance-Corey RG, et al. Clinical Insights Into CASPR1 and CASPR1/Contactin-1 Complex Autoimmune Nodopathies. Neurology. 2026;106(5):e214403. doi:10.1212/WNL.0000000000214403
Show transcript: 
Dr. Alexander Menze:
Hi, this is Alexander Menze. I just finished interviewing Divyanshu Dubey for the Neurology podcast. For today's Neurology Minute, I'm hoping you can tell us the main points of your paper.
Dr. Divyanshu Dubey:
Our paper talks about a rare form of autoimmune neuropathy associated with antibodies, CASPR1, as well as CASPR1/Contactin-1 complex IgG. These patients present with similar to CIDP, IDP, but tend to have more rapid progression, often a lot of sensory features preceding motor deficits including sensory ataxia in the contact and CASPR complex cases and presence of neuropathic pain in some of the CASPR1 cases. These patients, similar to other neuropathies are refractory to IVIg, but respond relatively well to rituximab.
 Dr. Alexander Menze:
Thank you. Be sure to download this week's podcast to hear our full interview.

Dr. Halley Alexander and Dr. Alissa M. D'Gama discuss genetic testing for infantile epilepsies. 
Show citation: 
Nguyen JNH, Lachgar-Ruiz M, Higginbotham EJ, et al. Diagnostic Yield of Comprehensive Reanalysis After Nondiagnostic Short-Read Genome Sequencing in Infants With Unexplained Epilepsy. Neurology. 2026;106(6):e214645. doi:10.1212/WNL.0000000000214645 
Show transcript: 
Dr. Halley Alexander: 
Hi, this is Halley Alexander with today's Neurology Minute, and I'm here with Dr. Alissa D'Gama from Boston Children's Hospital and Harvard Medical School, and we just finished recording a full-length podcast about some exciting new work in genetic testing for infantile onset epilepsies. Alissa, can you tell us what you found briefly and why it's important for neurology care?
Dr. Alissa D'Gama: 
Infantile epilepsies are relatively common, and they're associated with substantial burden of disease, and we know that identifying underlying genetic causes can impact clinical care. It's important for emerging precision therapies. But even after genome sequencing, which is the most comprehensive clinical genetic testing currently available, most infants remain genetically unsolved.
And so what we did was take that genome sequencing data and reanalyze it for a cohort of infants who had unexplained non-acquired epilepsy and non-diagnostic genome sequencing, and in about 5% of cases, our reanalysis was able to identify a genetic diagnosis, and all of these diagnoses had impact on clinical care for their infants and their families. In some cases, we could incorporate new information, either new clinical information about the patient or new scientific methods or information about disease associations, and in other cases, we were able to incorporate new analysis methods to identify variants. And so our findings suggest that implementing reanalysis for infants or any individual with epilepsy within a year or two of non-diagnostic testing may be useful.
Dr. Halley Alexander: 
Thank you so much, and you can find a lot more details by listening to the full-length podcast, which is available now on the Neurology podcast, and you can find the full article in the March 10th issue of Neurology or online at neurology.org. As always, thanks for tuning in for today's Neurology Minute.

In part three of this series, Dr. Jeff Ratliff discusses how access to information is not the same as clinical confidence.
Show transcript: 
Dr. Jeff Ratliff: 
Hi, this is Jeff Ratliff from Thomas Jefferson University, and this is your Neurology Minute.
I'm back again with a Neurology Minute episode to complement the podcast discussion I had with Roy Strowd, Justin Abbatemarco, and Tesha Monteith on the topic of technology-driven shifts in neurology education. In the episode, we touched on podcasting, AI-based learning, and social media on neurology education as a panel discussion.
While there is still tremendous utility and promise and excitement around these tools, I think it's still helpful for us all to remember that access to information is not the same as clinical confidence. With tools like podcasts, learners can hear expert discussions on their commute or review topics in new interactive formats. With AI tools, learners can simulate talking to patients with a multitude of neurologic conditions. These digital tools can provide answers at hours, and our learners fingertips much more readily than even recent years. But as we watch the explosion of these tools impact, we must keep in mind the value of bedside clinical teaching.
As teachers, as educators, there's still a great impact we can have by watching a resident examine a patient with ataxia, or coaching them through a difficult conversation with a patient. We can still help them teach the skill of reasoning through their clinical encounters in real time so that they can remember to ask that key history question, or to add in that critical exam maneuver. So, as impressive and impactful the latest and greatest teaching tool may be, I encourage you all not to shy away from going back to the bedside with the student, the resident, or fellow working with you today. Thanks for listening to the Neurology Minute. We'll see you next time.

In part two of this series, Dr. Jeff Ratliff discusses the expanding role of AI and digital tools in neurology education, emphasizing the importance of verifying information and developing source literacy. 
Show transcript: 
Dr. Jeff Ratliff:
Hi, this is Jeff Ratliff from Thomas Jefferson University, and this is your Neurology Minute.
I recently recorded a podcast episode with Roy Strowd, Justin Abbatemarco, and Tesha Monteith, where we discussed the growing impact of technology in neurology education. In this episode, we touched on podcasting, AI-based learning and social media in neurology education, all as a panel discussion. As an accompaniment to that conversation, we're releasing a series of Neurology Minute episodes, exploring those tools.
Today I want to focus an important caution, verification. With increasing use of digital tools, AI or otherwise. The need for caution and verification of sources is even more important. Large language models and other AI tools are very frequently used by trainees at all levels. To summarize topics, generate explanations, and even draft a differential diagnosis. But as you all know, the outputs of these tools can be efficient and really impressive, but we need to keep in mind that potential issues with reliability. While less and less common, these tools may hallucinate producing information that sounds authoritative and sounds correct, but it's actually outdated or maybe even unsupported by evidence.
So for those of us teaching at the bedside or in clinic, this means we have a responsibility to help our learners develop literacy towards AI and other digital tools. We have to be critics of our sources. As neurologists, we can role model asking questions like, where did this information come from and how do we verify it, and did you read the study that they cited? We encourage trainees to trace these claims back to the primary literature or to pull up guidelines or other trusted review sources just as we do in our own practice. I don't want to pour water on the AI enthusiasm. The truth is still that AI education tools can be a powerful adjunct for learning, but we should treat it like an assistant, not a supervisor. It's useful, it's fast, but it's still in need of our own supervision.
Please tune into our podcast discussion to hear more about the rapidly changing landscape of neurology education. Meanwhile, thanks for listening to the Neurology Minute.

In part two of this series, Dr. Tesha Monteith and Dr. Andrew Hershey discuss appropriate treatment strategies to prevent migraines in children and adolescents.
Show citation: 
Hershey AD, Szperka CL, Barbanti P, et al. Fremanezumab in Children and Adolescents with Episodic Migraine. N Engl J Med. 2026;394(3):243-252. doi:10.1056/NEJMoa2504546 
Show transcript: 
Dr. Tesha Monteith:
This is Tesha Monteith with the Neurology Minute. I'm back with Andrew Hershey, professor of Pediatrics and Director of the Division of Neurology at Cincinnati Children's and the Children's Headache Center. This is part two of our discussion on his paper published in the New England Journal of Medicine, fremanezumab in Children and Adolescents with Episodic Migraine.
Andrew, now that we have fremanezumab approved for prevention of episodic migraine in children and adolescents, and we have a number of other devices and treatments for patients that can be used as part of FDA-approved treatment or even off-label, can you discuss an appropriate treatment paradigm to prevent migraine?
Dr. Andrew Hershey:
I think the first and foremost part of the paradigm is to identify the disease, so recognition that headaches are a component of the disease migraine, so you have headaches attacks due to migraine is an essential part. Many of the children, adolescents and their families are unaware that that is even what they're having, and clarifying the etiology actually goes a long way. One of my former mentors, Dr. Prensky, always said that 50% of kids get better from just seeing a child neurologist, and I think it's that clarification of the diagnosis.
Second to that, you need to provide a very adequate acute treatment as well as what's probably even more essential than anything else is healthy lifestyle habits. So regular eating, drinking, sleeping, and exercise. And then finally, if the headache is causing severe disability or frequent headaches or interfering with the child's school, home or social life, the prevention medications may need to be added. And this is where the fremanezumab, or if you prefer devices, devices can be used for both the acute and preventive treatment.
Dr. Tesha Monteith:
Well, thank you for the summary, and congratulations again on your paper.
Dr. Andrew Hershey:
Thank you.
Dr. Tesha Monteith:
Do check out the full podcast for more details about the paper and treatment of migraine in children and adolescents. This is Tesha Monteith. Thank you for listening to the Neurology Minute.