Uploaded February 2025 | Updated September 2026, 1 week ago
In this episode of "Ask the Expert," Dr. Eoin Flanagan joined Dr. GG deFiebre of SRNA. Dr. Flanagan explained how immunosuppressive medications impact the immune system and the efficacy of vaccines [00:02:45]. He discussed the primary concerns and risks of vaccinating individuals on these therapies, including avoiding live vaccines and the need for additional booster doses [00:04:52]. Dr. Flanagan also talked about the recommended vaccines for those with conditions like MOG antibody disease (MOGAD) and neuromyelitis optica spectrum disorder (NMOSD), and underlined the importance of getting vaccinated to prevent severe infections [00:09:40]. He addressed common misconceptions and emphasized the role of healthcare providers in educating and supporting their patients regarding vaccinations [00:15:32].
Eoin Flanagan, MB, BCh is a Professor of Neurology and Consultant in the departments of Neurology and Laboratory Medicine and Pathology at the Mayo Clinic (Rochester, MN). He completed his medical school training at University College Dublin in Ireland in 2005. He did a medical residency in Ireland and then completed neurology residency, fellowships in neuroimmunology and a masters in clinical and translational science at Mayo Clinic (Rochester, MN). He works in the Autoimmune Neurology and Multiple Sclerosis Clinics and the Neuroimmunology Laboratory at the Mayo Clinic. His clinical expertise and research are focused on inflammatory myelopathies and their imaging patterns, myelin oligodendrocyte glycoprotein (MOG) antibody associated disorder, neuromyelitis optica spectrum disorders, autoimmune encephalitis, paraneoplastic neurologic disorders, and multiple sclerosis. He is principal investigator on an NIH RO1 grant studying MOG antibody associated disorder.
00:00 Introduction
00:47 Understanding Immunosuppressants and Vaccines
01:28 Primary Concerns with Vaccinating Immunosuppressed Patients
02:30 Recommended Vaccines for Immunosuppressed Patients
07:11 Timing and Effectiveness of Vaccinations
08:21 Measuring Vaccine Response
09:24 Addressing Missed Doses and Safety Considerations
16:41 Public Health Implications and Patient Advocacy
17:56 Advice for Vaccine-Hesitant Patients
19:06 Healthcare Providers' Role in Vaccination
20:03 Conclusion and Final Thoughts
In this episode of "Ask the Expert," Dr. Eoin Flanagan joined Dr. GG deFiebre of SRNA. Dr. Flanagan explained how immunosuppressive medications impact the immune system and the efficacy of vaccines [00:02:45]. He discussed the primary concerns and risks of vaccinating individuals on these therapies, including avoiding live vaccines and the need for additional booster doses [00:04:52]. Dr. Flanagan also talked about the recommended vaccines for those with conditions like MOG antibody disease (MOGAD) and neuromyelitis optica spectrum disorder (NMOSD), and underlined the importance of getting vaccinated to prevent severe infections [00:09:40]. He addressed common misconceptions and emphasized the role of healthcare providers in educating and supporting their patients regarding vaccinations [00:15:32].
Eoin Flanagan, MB, BCh is a Professor of Neurology and Consultant in the departments of Neurology and Laboratory Medicine and Pathology at the Mayo Clinic (Rochester, MN). He completed his medical school training at University College Dublin in Ireland in 2005. He did a medical residency in Ireland and then completed neurology residency, fellowships in neuroimmunology and a masters in clinical and translational science at Mayo Clinic (Rochester, MN). He works in the Autoimmune Neurology and Multiple Sclerosis Clinics and the Neuroimmunology Laboratory at the Mayo Clinic. His clinical expertise and research are focused on inflammatory myelopathies and their imaging patterns, myelin oligodendrocyte glycoprotein (MOG) antibody associated disorder, neuromyelitis optica spectrum disorders, autoimmune encephalitis, paraneoplastic neurologic disorders, and multiple sclerosis. He is principal investigator on an NIH RO1 grant studying MOG antibody associated disorder.
00:00 Introduction
00:47 Understanding Immunosuppressants and Vaccines
01:28 Primary Concerns with Vaccinating Immunosuppressed Patients
02:30 Recommended Vaccines for Immunosuppressed Patients
07:11 Timing and Effectiveness of Vaccinations
08:21 Measuring Vaccine Response
09:24 Addressing Missed Doses and Safety Considerations
16:41 Public Health Implications and Patient Advocacy
17:56 Advice for Vaccine-Hesitant Patients
19:06 Healthcare Providers' Role in Vaccination
20:03 Conclusion and Final Thoughts

![2024 RNDS | Community Perspectives Panel: Navigating Work, Travel, Setting Boundaries, and More
At the 2024 RNDS, this panel of community members discussed the benefits of setting boundaries while travelling and with colleagues, family members, and friends [00:00:10]. Rebecca Salky shared her journey on learning to say no and prioritizing her rest [00:01:12]. Philip Rive highlighted the challenges of accepting limited capacities and focusing on quality over quantity [00:03:24]. Leah Campbell emphasized the importance of time management and clear communication about invisible disabilities [00:06:45]. Please note that the information shared during this session is for informational purposes only and is not medical advice.
00:00 Introduction to Community Perspectives
00:24 The Importance of Setting Boundaries
01:00 Personal Experiences with Boundaries
03:13 Invisible Disabilities and Communication Challenges
07:10 Navigating Work with Health Conditions
11:56 Adapting to Changes and Finding Balance
16:34 Travel Challenges and Solutions
23:18 Living Life to the Fullest Despite Limitations
25:18 Conclusion and Final Thoughts 2024 RNDS | Community Perspectives Panel: Navigating Work, Travel, Setting Boundaries, and More](https://i.ytimg.com/vi/F1olXRYdBcY/mqdefault.jpg)




![2024 RNDS | A Conversation: How Do I Identify a Relapse?
At the 2024 RNDS, Rebecca Salky, RN shared her journey of living with MOG antibody disease (MOGAD) from childhood to adulthood and the numerous relapses she experienced [00:00:00]. Dr. Cynthia Wang discussed the complexities of diagnosing and treating relapses, using a fire analogy to illustrate her points [00:02:34]. Audience members shared their personal experiences and challenges with managing symptoms, emphasizing the need for better communication and support among doctors [00:10:15]. Rebecca and Dr. Wang provided practical tips for patients on how to handle relapses and pseudo-relapses, and the importance of seeking comprehensive care [00:18:59]. Please note that the information shared during this session is for informational purposes only and is not medical advice.
00:00 Introduction and Personal Story
00:43 Understanding Relapses: Dr. Wangs Perspective
01:25 Fire Analogy: Explaining Relapse and Treatment
03:32 Personalizing Treatment and Recognizing Symptoms
05:59 Challenges in Diagnosis and Treatment
10:15 Patient Experiences and Questions
16:59 Community Support and Future Improvements
18:59 Emergency Strategies and Final Advice 2024 RNDS | A Conversation: How Do I Identify a Relapse?](https://i.ytimg.com/vi/HJADluTdy1E/mqdefault.jpg)
![1302. Pelvic Floor Therapy for Bladder and Bowel Management
Krissy Dilger of SRNA moderated this Ask the Expert episode, “Pelvic Floor Therapy for Bladder and Bowel Management,” featuring Jessica Ekberg, a certified pelvic floor therapist. Jessica explained the various conditions treated by pelvic floor therapy, emphasizing the importance of posture and breathing [00:01:05]. She discussed how pelvic floor therapy is adapted for individuals with rare neuroimmune disorders [00:04:59]. The discussion included both physical exercises and emotional work integral to the therapy [00:07:42]. Practical tips for seeking pelvic floor therapy and insurance considerations were also covered [00:10:42]. The episode concluded with encouragement to explore this underutilized service [00:19:23].
00:00 Introduction
02:03 Understanding Pelvic Floor Therapy
04:59 Pelvic Floor Therapy for Rare Neuroimmune Disorders
07:42 The Emotional and Mental Aspects of Pelvic Floor Therapy
10:42 Practical Insights and Patient Experiences
19:23 Getting Started with Pelvic Floor Therapy
27:38 Conclusion
Jessica Ekberg, OTR/L is a business owner, avid runner, former pants peer, prolapse owner, postpartum pain sufferer, mom of two, and certified pelvic floor therapist. Jessica is extremely passionate about helping men and women be the best version of themselves they can. Her goal is to bring Pelvic Floor Health discussions to the forefront of what she does, to help dispel myths and educate about facts. The lack of information and effective treatment in the community can leave people suffering in silence. Now that she has been working in pelvic health for almost five years, she realizes just how critical pelvic health is to all of us. She started her pelvic health journey after experiencing “a lot of problems” when returning to running post baby.
Jessica’s advice is to stop ignoring or putting off taking care of yourself. The core makes up the foundation of the body and if it is not functioning properly, it can impact several systems within the body. Some of the problems that clients present with are incontinence, hernias, pelvic pain including hips/back/genital/rectal/tailbone, respiratory difficulties, heavy/painful periods, menopause, endometriosis, pre/during/postpartum care, constipation, and sexual (including erectile) dysfunction. Jessica’s approach involves assessing the whole body, putting the puzzle together in order to determine the driver of the dysfunction and then developing a treatment plan to solve the problem. Her goal is to help clients return to doing all of the things they love, as quickly and safely as possible. 1302. Pelvic Floor Therapy for Bladder and Bowel Management](https://i.ytimg.com/vi/HgN1enJqJ2E/mqdefault.jpg)
![ABCs of NMOSD 702. CAR-T in NMOSD
Dr. GG deFiebre of SRNA spoke with Dr. Michael Levy and Dr. Benjamin Greenberg about CAR-T therapy for aquaporin-4-positive NMOSD.
They described why targeting B cells may reduce aquaporin-4 antibodies over time and could enable long-term remission or reduced need for ongoing drugs [01:37]. The physicians outlined an autologous Phase 1 study at Mass General and UT Southwestern [07:02]. They discussed eligibility rationale, key risks such as infection, cytokine release syndrome and ICANS, and how lessons from this NMOSD-focused trial could inform future neuroimmune disorder research [09:10]. You can find more information about the trial here:
https://clinicaltrials.gov/study/NCT07573332?cond=NMOSD&intr=CAR-T&viewType=Card&rank=1
Benjamin M. Greenberg, MD, MHS is a Professor and the Cain Denius Scholar in Mobility Disorders in the Department of Neurology [https://utswmed.org/why-utsw/departments/neurology/] at UT Southwestern Medical Center in Dallas, Texas. He currently serves as the Vice Chair of Translational Research and Strategic Initiatives for the Department of Neurology. He is also the interim Director of the Multiple Sclerosis Center [https://utswmed.org/locations/aston/multiple-sclerosis-and-neuroimmunology-clinic/] and the Director of the Neurosciences Clinical Research Center. In addition, he serves as Director of the Transverse Myelitis and Neuromyelitis Optica Program and the Pediatric Demyelinating Disease Program [https://www.childrens.com/specialties-services/specialty-centers-and-programs/neurology/demyelinating-disease-program] at Children’s Medical Center.
Dr. Greenberg earned his medical degree at Baylor College of Medicine before completing an internal medicine internship at Chicago’s Rush Presbyterian-St. Luke’s Medical Center. He performed his neurology residency at the Johns Hopkins School of Medicine. He also holds an M.H.S. in molecular microbiology and immunology from the Bloomberg School of Public Health, as well as a bachelor’s degree in the history of medicine – both from Johns Hopkins. Prior to his recruitment to UT Southwestern in 2009, Dr. Greenberg was on the faculty of the Johns Hopkins Division of Neuroimmunology, serving as the Director of the Encephalitis Center and Co-Director of the nation’s first dedicated Transverse Myelitis Center.
Dr. Greenberg splits his clinical time between adult and pediatric patients at William P. Clements Jr. and Zale Lipshy University Hospitals, Parkland, and Children’s Medical Center. His research focuses on better diagnosing, prognosticating, and treating demyelinating diseases and nervous system infections. He also coordinates clinical trials to evaluate new treatments to prevent neurologic damage and restore function to affected patients.
Michael Levy, MD, PhD is a recognized neurologist with over 15 years of clinical and research expertise in rare neuroimmunological disorders. He established the Neuroimmunology Clinic and Research Laboratory at Massachusetts General Hospital and is the Research Director in the Division of Neuroimmunology and Neuroinfectious Disease. Previously, Dr. Levy was on the faculty at Johns Hopkins University and was the founding Director of their Neuromyelitis Optica Clinic.
Clinically, Dr. Levy cares for patients with MOG antibody disease (MOGAD), neuromyelitis optica spectrum disorder (NMOSD), and idiopathic transverse myelitis (TM). Dr. Levy is also the principal investigator (PI) on numerous patient studies and drug trials for new and improved treatments for these disorders. In 2022, Dr. Levy became the lead principal investigator for the two worldwide clinical trials in MOG antibody disease.
In the lab, Dr. Levy’s research focuses on the development of animal models of NMO and MOG with the goal of tolerization as a sustainable long-term treatment. Dr. Levy has more than 200 peer-reviewed research articles, reviews and editorials, and 3 patents covering NMO tolerization therapy, TM diagnostics, and stem cell regeneration approaches.
00:00 Welcome and Guests
01:37 CAR-T Explained Simply
03:27 Immune Reset vs Suppression
04:37 Why Target aquaporin-4-positive NMOSD
06:05 One-Time Remission Goal
07:02 Trial Overview and Patient Journey
09:10 Eligibility and Medication Rules
11:20 Conditioning Chemo Purpose
13:02 Safety Risks and Monitoring
16:30 Why Criteria Are Strict
20:24 How to Join the Study
22:58 Future Questions and Wrap-Up ABCs of NMOSD 702. CAR-T in NMOSD](https://i.ytimg.com/vi/HlAlJl97NQ0/mqdefault.jpg)

