Refractory Headache Disorders, New Consensus, and Emergency Department Migraine Guidelines - Part 1
Neurology Minute
In part one of this series, Dr. Tesha Monteith and Dr. Jennifer Robblee discuss an international consensus definition for refractory migraine and why clearer criteria are needed. Show citations: Robblee J, Minen MT, Friedman BW, Cortel-LeBlanc MA, Cortel-LeBlanc A, Orr SL. 2025 Guideline Update to Acute Treatment of Migraine for Adults in the Emergency Department: The American Headache Society Evidence Assessment of Parenteral Pharmacotherapies. Headache. 2026;66(1):53-76. doi: Robblee J, Khan FA, Marmura MJ, et al. Reaching International Consensus on the Definition of Refractory...
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Lab Minute: Vitamin B7
Neurology Minute
Dr. Stacey Clardy reviews biotin deficiency and biotin-related lab interference. Show transcript: Dr. Stacey Clardy: Hi, this is Stacey Clardy from the Salt Lake City VA and the University of Utah, and I'm back with you for another lab minute. Today, let's talk about Biotin or vitamin B7, because the Biotin story in neurology has two very different aspects. The first is a real deficiency, which is uncommon, but clinically really important. And the second is the modern problem of biotin supplementation that's quietly wrecking our lab interpretation. So first, true biotin deficiency in...
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February 23, 2026 Capitol Hill Report: Neurology on the Hill
Neurology Minute
In this episode, Dr. Stacey Clardy reviews the February 23rd Capitol Hill Report, recapping key takeaways from Neurology on the Hill. Stay updated with what’s happening on the hill by visiting . Learn how you can get involved with . Show transcript: Dr. Stacey Clardy: Hi, this is Stacey Clardy with today's Neurology Minute. It's an advocacy update from the AAN's Capitol Hill Report. More than 200 AAN members came to Washington, DC, last week for the AAN's annual advocacy fly-in, Neurology on the Hill. As you probably know, this is the annual chance for...
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March 2026 President Spotlight: Preview of the Annual Meeting
Neurology Minute
In the March episode of the President's Spotlight, Dr. Jason Crowell and Dr. Natalia Rost share key updates and strategic insights for the upcoming April meeting in Chicago. Stay informed by watching the video. Show transcript: Dr. Jason Crowell: Hey, this is Jason Crowell. Thanks for listening to today's Neurology Minute. Once again, this month, we have Natalia Rost joining us, the president of the AAN for her presidential spotlight. Natalia, the sun is starting to come out. The flowers are starting to bloom. Spring is here. What is going on with the academy?...
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The Best of Headache Medicine from 2025: A Year in Review
Neurology Minute
Dr. Tesha Monteith and Dr. Patricia Pozo-Rosich discuss the latest advancements in headache medicine, focusing on key research findings from 2025. Show transcript: Dr. Tesha Monteith: Hi, this is Tesha Monteith with the Neurology Minute. Welcome to our 2026 Headache Medicine Series. I've just been speaking with Patricia Pozo-Rosich about all of the exciting advances in headache medicine in 2025. For a minute, why don't you summarize some of the key advances in headache medicine research? Dr. Patricia Pozo-Rosich: I think that we have good news in headache. We are currently phase two...
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Overview from the 2026 International Stroke Conference - Part 2
Neurology Minute
In part two of the series, Dr. Andy Southerland and Dr. Seemant Chaturvedi break down key takeaways from the OCEANIC‑STROKE trial. Show citation: Read more about the . Show transcript: Dr. Andy Southerland: Hello everyone. This is Andy Southerland from the University of Virginia. For today's Neurology Minute, I've just been speaking with my colleague, Seemant Chaturvedi from the University of Maryland, about exciting trials presented at this year's 2026 International Stroke Conference from the American Heart Association, American Stroke Association. And the...
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Overview from the 2026 International Stroke Conference - Part 1
Neurology Minute
In part one of this series, Dr. Andy Southerland and Dr. Seemant Chaturvedi discuss two trials highlighted at the 2026 International Stroke Conference. Show citation: Read more about the . Show transcript: Dr. Andy Southerland: Hello everyone. This is Andy Southerland. And for this week's Neurology Minute, I have just been speaking once again with my colleague, Seemant Chaturvedi, about his impressions from this year's 2026 American Heart Association, American Stroke Association International Stroke Conference. We've discussed a number of the very exciting pivotal...
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How Non-Traditional Educational Formats are Reshaping Neurology Training - Part 4
Neurology Minute
In part four of this series, Dr. Tesha Monteith explores the true potential of AI integration in medical education. Show transcript: Dr. Tesha Monteith: Hi. This is Tesha Monteith with the Neurology Minute. I've been speaking with Roy Strowd, Jeff Ratliff, and Justin Abbatemarco about the use of AI in neurology education for the neurology podcast. My take is that we're just getting started with this stuff, including the true potential of AI integration in medical education. In my regular work, I used AI to generate clinical case vignettes that help trainees practice diagnostic...
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Consensus Recommendations for Diagnosis and Management of Vanishing White Matter - Part 2
Neurology Minute
In part two of this series, Dr. Justin Abbatemarco, Dr. Marjo S. van der Knaap, and Romy J. van Voorst discuss the patient management card and how patients should use it. Show citation: and Clinical Management of Vanishing White Matter. Neurology. 2025;105(11):e214320. doi: Show transcript: Dr. Justin Abbatemarco: Hello and welcome back. This is Justin Abbatemarco here with Romy J. van Voorst and Dr. Marjo S. van der Knaap. After discussing her article, Published Neurology Consensus Base Expert Recommendation for Diagnosis and Clinical Management of Vanishing White Matter...
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2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke
Neurology Minute
Dr. Andy Southerland and Dr. Shyam Prabhakaran explain the significance of these guidelines and why they are important. Show citation: Prabhakaran S, Gonzalez NR, Zachrison KS, et al. 2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association. Stroke. Published online January 26, 2026. doi: Show transcript: Dr. Andy Southerland: Hello everyone. This is Andy Southerland from the University of Virginia. And for this week's Neurology Minute, I've just been speaking with my...
info_outlineDr. Aaron Zelikovich discusses recent survey findings highlighting the wide variability in how clinicians evaluate and diagnose small fiber neuropathy.
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Show citation:
Thawani S, Chan M, Ostendorf T, et al. How Well do We Evaluate Small Fiber Neuropathy?: A Survey of American Academy of Neurology Members. J Clin Neuromuscul Dis. 2025;26(4):184-195. Published 2025 Jun 2. doi:10.1097/CND.0000000000000502
Show transcript:
Dr. Aaron Zelikovich:
Welcome to today's Neurology Minute. My name is Aaron Zelikovich, a neuromuscular specialist at Lenox Hill Hospital in New York City. Today, we will discuss a recent article, How Well Do We Evaluate Small Fiber Neuropathy? A survey of The American Academy of Neurology members, which evaluates small fiber neuropathy in clinical practice.
The current landscape of evaluating and testing for small fiber neuropathy remains highly variable in regards to serum testing, skin biopsy, and nerve conduction studies. In this survey study, 800 members of The American Academy of Neurology were randomly selected and emailed a survey. 400 neuromuscular physicians and 400 non-neuromuscular physicians were selected. The overall response rate was 30% with half of the completed surveys coming from neuromuscular physicians. The most common overall initial blood work for this patient population was a CBC, vitamin B12, basic metabolic profile, TSH, and hemoglobin A1C. Other high yield blood tests included ESR, SPEP, immunofixation, and ANA. 70% of responders would also order a nerve conduction study as part of the initial workup. Second line evaluation had less consensus and included skin biopsies for intraepidermal nerve fiber density, hepatitis panel, HIV, and paraneoplastic testing. Responders noted that if the patient had acute onset of symptoms, had symptoms that were asymmetric, or being under 30 years old, they would order a more extensive workup.
The authors discussed the importance of both clinical exam, history, and diagnostic workup in patients with symptoms compatible with small fiber neuropathy. They highlight that there is no current objective gold standard for a diagnosis of small fiber neuropathy. The current diagnostic recommendation by the AAN for distal symmetric polyneuropathy includes serum blood sampling for glucose, vitamin B12, SPEP, and immunofixation. Clinical practice in the diagnosis of small fiber neuropathy remains highly variable based on the provider and clinical context of the patient.
Neurology Practice Current is currently accepting surveys on clinical practice patterns for patients with small fiber neuropathy. Please check out the link in today's Neurology Minute to complete the survey. Thank you and have a wonderful day.