Neurology® Podcast

March 2025 Recall: Topics on Peripheral Neuropathy and Radiculopathy

Mar 1, 2025

Dr. Anne Oaklander, an Associate Professor of Neurology at Harvard, discusses the connection between long COVID and small fiber neuropathy, shedding light on significant diagnostic challenges. She also shares effective management strategies. Dr. Carmel Armon from Loma Linda University tackles the efficacy of epidural steroid injections for spinal issues, presenting mixed results. The conversation highlights the importance of personalized treatment plans and improved research for managing neuropathic pain and conditions like diabetic neuropathy.

01:14:44

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Episode guests

Carmel Armon

Anne Oaklander

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Quick takeaways

Research indicates a significant association between long COVID and the onset of small-fiber neuropathies, highlighting diagnostic challenges in recovery.

New practice guidelines for painful diabetic neuropathy emphasize a holistic treatment approach that includes addressing mood and sleep disorders.

Recent studies show limited efficacy of epidural steroid injections for cervical and lumbar radiculopathies, necessitating better patient counseling on outcomes.

Deep dives

Understanding Peripheral Neuropathy in Long COVID

The emergence of peripheral neuropathy in patients recovering from COVID-19 has raised significant clinical interest. Research indicates that many individuals experience new neuropathies well after the virus's onset, with symptoms often beginning within a month of infection. In a study comprising 17 patients, skin biopsy and autonomic testing were found to be especially revealing diagnostics, where over 60% of participants exhibited abnormal findings. Most notably, the study suggested that a substantial number of these cases were small fiber neuropathies, aligning with broader trends observed in long COVID symptoms that overlap with those of fibromyalgia and chronic fatigue syndrome.

Intro

2min

Exploring Peripheral Neuropathy Linked to Long COVID

5min

Understanding Neuropathies Post-COVID-19

22min

Navigating Autoimmunity and Pregnancy in Young Patients

3min

Exploring Infectious Triggers in Acute Neuropathy

3min

Managing Small Fiber Neuropathy in Women: Implications of Pregnancy and Autoimmunity

8min

Navigating Neuropathic Pain Management

16min

Evaluating Epidural Steroid Injections

15min

The March 2025 replay features four previously released episodes focused on peripheral neuropathy and radiculopathy. The episode begins with Dr. Anne Oaklander discussing the association between long COVID and the development of polyneuropathy affecting small-fiber axons. This is followed by another interview with Dr. Oaklander, where she shares key takeaways for clinicians regarding the management of small-fiber neuropathy. The third segment features Drs. Raymond Price and Brian Callaghan discussing practice guidelines for painful diabetic neuropathy. The episode concludes with Dr. Carmel Armon addressing the efficacy of epidural steroid injections in treating cervical and lumbar spinal stenosis and radiculopathies.

Podcast Links:

Peripheral Neuropathy and Prolonged COVID

Relapsing-Remitting Immunotherapy Responsive SFN

Practice Guidelines for Painful Diabetic Neuropathy

Epidural Steroids for Cervical and Lumbar Radicular Pain and Spinal Stenosis

Article Links:

Peripheral Neuropathy Evaluations of Patients With Prolonged Long COVID

Relapsing-Remitting Immunotherapy Responsive Small-Fiber Neuropathy

Epidural Steroids for Cervical and Lumbar Radicular Pain and Spinal Stenosis Systematic Review Summary

Disclosures can be found at Neurology.org.