Levodopa did not improve motor recovery after stroke in an updated Cochrane review

The edition in brief

An updated Cochrane review of 12 randomised trials (1,860 patients) found no evidence that levodopa or dopamine agonists improve motor function after stroke; the two trials at low risk of bias, covering most participants, showed a standardised mean difference of 0.02, with no difference in serious adverse events. A Spanish multicentre registry of 31 patients with focal refractory or super-refractory status epilepticus found cenobamate, started at a median 50 mg daily after five failed drugs, was followed by sustained termination in 84%, and in a matched comparison was associated with higher resolution (82% vs 57%); this is Class IV evidence. A post hoc analysis of the ATTENTION trial found baseline MRI and CT gave similar 90-day outcomes in basilar artery occlusion, without workflow delay. A meta-analysis of four tolebrutinib trials suggests reduced disability progression in non-relapsing secondary progressive MS, but evidence is preliminary. The pearl covers status epilepticus timing.