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Neuropathy Treatments

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Introduction

Intranasal administration via the Shenocatheter allows exosomes to bypass the blood–brain barrier through the olfactory and trigeminal pathways. Neural exosomes may support neuroinflammation reduction, neuronal repair signaling, and modulation of dysregulated imbic circuitry associated with PTSD.

Indications and Viable Conditions

Perinatal stem cell IM therapy may be considered in patients with:

  • Peripheral neuropathy (idiopathic, metabolic, post-infectious, or traumatic)

  • Diabetic neuropathy

  • Chemotherapy-induced neuropathy

  • Post-surgical or post-traumatic nerve irritation

  • Sensory disturbances including numbness, tingling, burning, or neuropathic pain

Greatest potential is in patients with persistent pain, weakness, or MRI-confirmed muscle pathology where conservative care has failed.

Contraindications

  • Active infection at injection site

  • Coagulopathy or uncontrolled bleeding disorders (relative contraindication)

  • Severe peripheral vascular disease at injection site

Dosing Considerations

  • EXO-NeuralTM (Localized Injection):

    • Administer small aliquots distributed circumferentially around the affected nerve or

    region

    • Avoid direct intraneural injection

    • Total volume per session determined by extent of neuropathy and clinical judgment

    EXM IM Injection:

    • Total dose: 2.0 cc

    • Injection site: Deltoid or glute (maximum 2 cc per deltoid, up to 5 cc per glute)

    Procedure:

    1. Identify affected neural distribution and mark injection sites.

    2. Prepare skin using standard sterile technique.

    3. Inject EXO-NeuralTM peri-neurally around affected area using small-volume injections.

    4. Administer 2.0 cc EXM IM into selected muscle.

    5. Observe patient for 10–15 minutes post-procedure.

Treatment Frequency

• Initial series: Every 2–4 weeks for 2–4 treatments

• Maintenance: Every 6–8 weeks as clinically indicated

Conclusion

Intramuscular delivery of perinatal MSCs is an emerging regenerative option for patients with chronic muscle pathology, myopathy, or ischemia-related weakness. By leveraging the paracrine signaling and trophic factors of perinatal MSCs, this therapy may promote angiogenesis, reduce fibrosis, and enhance functional recovery. Careful patient selection, appropriate dosing by muscle group, and technical expertise in musculoskeletal injections are essential to optimize outcomes and minimize risk.

Regulatory Disclaimer

This protocol is intended for physician-directed clinical use. Exosome-based therapies are investigational and not FDA approved for the treatment of peripheral neuropathy. This protocol is not intended to diagnose, treat, cure, or prevent disease.

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