Microneurography Reveals Unmyelinated Small Nerve Fiber Dysfunction in Long COVID, 2025, Ribeiro et al.

jaded said:
I’ve tried to get nhs support from neuroimmunology despite all of my objective tests including microneurography and a skin biopsy, CPET at Papworth etc but because the underlying cause isn’t known e.g secondary to lupus or vasculitis they’re not interested.
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I have the advantage that being even more of an immunologist myself I can tell the neuroimmunologist what he is supposed to think rather than the other way around! All I need are his third person examination skills and maybe some electrical tests.
 
Jonathan Edwards said:
I have the advantage that being even more of an immunologist myself I can tell the neuroimmunologist what he is supposed to think rather than the other way around! All I need are his third person examination skills and maybe some electrical tests.
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Agreed. However following my similar requests for help having a healthcare background, these doctors have often responded “there’s no point in doing further investigations if it won’t change management” and we can do that now anyway. At least symptomatically with available neuropathic meds. Which I’ve personally found to have been near on useless. The search for the underlying cause doesn’t seem to be on their radar if you don’t fulfil the standard boxes e.g diabetes, b12 deficiency etc.

And of course if they’ve made up their minds almost immediately it’s FND they will resist investigations feeding into the if “I do them she’ll truly think there is something medically wrong with her narrative”.
 
EndME said:
No information on controls?
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I have not looked through the paper in detail but I do wonder how much one can make of a series like this. It might be interpreted as saying ' some people with symptoms of neuropathy (who had also not been feeling good after Covid) who came to the neurology clinic were tested and a lot of them had signs of neuropathy.' And they would wouldn't they (whether or not they had had Covid).

There is also the issue of subjective scoring. Neurophysiology can be reasonably objective but there may also be significant scope for getting the results you expect.
 
It’s interesting as I wouldn’t have classified myself as having signs of neuropathy when I got referred for testing at the clinic other than the umbrella terms of fibromyalgia, pots/OI and ME. However they’re still finding the same set of results in a post covid cohort.

They seem to say all the symptoms that come along with ME/post Covid can be attributed to this neuropathy. My main question is, is the neuropathy secondary to an immune mediated process. And if that can be targeted how much of the downstream neuropathic process can be reversed.
 
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