Welcome to today's Neurology Minute.

I'm Aaron Zelikovich, a neuromuscular specialist at Lenox Hill Hospital in New York City.

Today, I'll be discussing a recent article, Efficacy and Safety of Gryphilimab and Generalized Myasthenia Gravis, a Phase III randomized clinical trial published in JAMA Neurology in September of 2026.

Gifrullimab is a novel nanobody targeting complement protein C5 that has demonstrated efficacy in the treatment of acetylcholine receptor antibody-positive generalized myasthenia gravis.

Generalized myasthenia gravis is an antibody-mediated disease that affects the extraocular bulbar and proximal limb muscles.

The most common pathogenic antibody in generalized myasthenia gravis targets the acetylcholine receptor.

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Hi, everyone.

This is Aaron Zelikovsky with the Neurology Minute.

I am back again following the recording of a podcast episode with my colleague, Bhaskar Roy, describing his paper published in Neurology, Bayesian Meta-analysis on all the new myasthenia gravis treatments in the past decade.

Bhaskar, based on your study showing similar efficacy with all the new therapies in myasthenia gravis, how do you recommend neurologists navigate these treatment decisions for patients who have myasthenia gravis?

And we can go on from there depending on their response and their preferences.

Thanks, Bhaskar.

Bhaskar's paper was published in the August eleven, two thousand and twenty-six issue of Neurology.

What have we learned thus far from the minimal evidence that we do have right now?

We're going to separate these into two groups.

So the first group of patients are the young children who have been dosed with gene therapy, either part of newborn screening or early identification.

who are not developing normally, it's pretty clear to us that a second agent, whether it's oral SMN modification or intrathecal SMN modification, is essential to either preserve the function that they have or to allow them to improve.

And I think the scientific community has pretty much adopted that, and we follow the post-gene therapy kids very closely, and the earliest signs that their motor function is declining, then we start to add a second agent.

In the younger kids, sorry, the older kids and the older adults, it's a much more nuanced discussion, right? Because typically what happens when patients switch therapies It's because of side effects or tolerability or inability to tolerate procedures.

There really is no evidence about meeting certain milestones from a motor standpoint to then add on a second therapy or to bring it down.

So from your end of things, and obviously somebody who is so entrenched in the research side of the realm, what more do we need to be doing from a research end? And what more can the clinical community be doing to kind of further advance this conversation so we can maybe have a few more answers within the next couple of years per se? Yeah.

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Welcome to today's Neurology Minute.

I'm Aaron Zelikovich, a neuromuscular specialist at Lenox Hill Hospital in New York City.

Today, I'll be discussing a recent article, "Vamorolone for Duchenne Muscular Dystrophy: A Cross-Trial Efficacy Comparison with Classic Corticosteroids from the 4DMD Trial," published in Neurology.

Vamorolone is a novel dissociative corticosteroid developed as an alternative to traditional agents such as prednisone and deflazacort.

In a twenty-four week study, it demonstrated similar efficacy to prednisone with potential benefits in reducing growth suppression.

Duchenne muscular dystrophy, or DMD, is an X-linked progressive muscle disorder caused by mutations in the dystrophin gene.

Welcome to today's Neurology Minute.

I'm Aaron Zelikovich at Lenox Hill Hospital in New York City.

Today, I'll be discussing a recent article published in Lancet Neurology titled, Efficacy and Safety of Chemdisoran Silencing RNA in Myasthenia Gravis, the NIMBL trial, a double-blind, randomized, placebo-controlled phase 3 study.

Chemdisoran monotherapy showed modest improvement in symptoms of generalized myasthenia gravis compared to placebo.

Recent therapeutic strategies have targeted the FCRN receptors and complement-mediated pathways.

In particular, C5 complement inhibitors such as ecolizumab, ravelizumab, and zilocoplant have demonstrated clinical benefit in large phase III trials.

Hear directly from leading Rett Syndrome experts as they discuss real-world treatment strategies in an engaging video series created for healthcare providers, available at learnaboutrett.com.

Welcome to today's Neurology Minute.

My name is Aaron Zelikovich, a neuromuscular specialist at Lenox Hill Hospital in New York City.

Today, I'll be discussing a recent article titled, Low Prevalence and Inconsistency of LRP4 IgG Detection in Suspected Myasthenia Gravis that was published in Neurology, Neuroimmunology, and Neuroinflammation.

The key takeaway is that LRP4 antibodies are neither sensitive nor specific for myasthenia gravis and are not currently recommended as part of the routine diagnostic workup.

Myasthenia gravis is an autoimmune disorder of the neuromuscular junction in which autoantibodies impair neuromuscular transmission, which leads to clinical symptoms of fluctuating weakness.

The two most common antibodies associated with myasthenia gravis are the acetylcholine receptor and musk antibodies.

Hear directly from leading Rett Syndrome experts as they discuss real-world treatment strategies in an engaging video series created for healthcare providers, available at learnaboutrett.com.

Welcome to today's Neurology Minute.

My name is Dr. Aaron Zelikovich, a neuromuscular specialist at Lenox Hill Hospital in New York City.

Today, we'll discuss part three of a three-part series reviewing a recent article titled, Safety and Efficacy of Adjunct Dexamethasone in Adults with Herpes Simplex Virus Encephalitis in the United Kingdom, a multi-center, observer-blind, randomized, phase three controlled trial published in The Lancet Neurology.

In this episode, we'll focus on the clinical outcomes observed during and after the acute infection and how these findings can inform physicians counseling patients in both acute HSV encephalitis and its long-term sequelae.

Mortality from HSV encephalitis remains at approximately 10% and 50% of survivors have moderate to severe disability long-term and only 20% of patients can return to their jobs.

Herpes simplex virus encephalitis is a strong predilection for the temporal lobes, which correlates with the patient's acute and long-term complications.