This session will address common challenges in the pharmacological management of neuroimmunological conditions. The discussion will begin with special populations, including pregnant and lactating women and older adults. These life stages are characterized by the potential for spontaneous remission of certain neuroimmunological conditions; therefore, the session will examine the safety and appropriateness of disease-modifying treatments (DMTs) during these periods. The first part of the session will conclude with a focus on vaccination in patients with neuroimmunological conditions, emphasizing vaccine safety and interactions with DMTs, particularly in the contexts of pregnancy, breastfeeding, and advanced age. The second part of the session will address additional special populations. The discussion will first examine perioperative cases and the risk of infection in patients receiving DMTs for neuroimmunological conditions, with an emphasis on practical recommendations informed by DMT half-life and the potential for disease rebound. Next, the management of patients with autoimmune conditions other than multiple sclerosis will be discussed, highlighting potential interactions between DMTs and the development of demyelinating conditions as adverse effects of certain DMTs used for systemic autoimmune diseases. Finally, logistical and practical considerations regarding the use of DMTs for neuroimmunological conditions in veterans with neuroimmunological diseases will be reviewed. At the end of the session, the audience should learn about: • Treating neuroimmunological diseases at special times of life • Treating neuroimmunological diseases in patients with systemic autoimmune diseases • Using Vaccines in patients with neuroimmunological diseases • Treating neuroimmunological diseases at the VA Level of information: IntermediateThis session will address common challenges in the pharmacological management of neuroimmunological conditions. The discussion will begin with special populations, including pregnant and lactating women and older adults. These life stages are characterized by the potential for spontaneous remission of certain neuroimmunological conditions; therefore, the session will examine the safety and appropriateness of disease-modifying treatments (DMTs) during these periods. The first part of the session will conclude with a focus on vaccination in patients with neuroimmunological conditions, emphasizing vaccine safety and interactions with DMTs, particularly in the contexts of pregnancy, breastfeeding, and advanced age. The second part of the session will address additional special populations. The discussion will first examine perioperative cases and the risk of infection in patients receiving DMTs for neuroimmunological conditions, with an emphasis on practical recommendations informed by DMT half-life and the potential for disease rebound. Next, the management of patients with autoimmune conditions other than multiple sclerosis will be discussed, highlighting potential interactions between DMTs and the development of demyelinating conditions as adverse effects of certain DMTs used for systemic autoimmune diseases. Finally, logistical and practical considerations regarding the use of DMTs for neuroimmunological conditions in veterans with neuroimmunological diseases will be reviewed. At the end of the session, the audience should learn about: • Treating neuroimmunological diseases at special times of life • Treating neuroimmunological diseases in patients with systemic autoimmune diseases • Using Vaccines in patients with neuroimmunological diseases • Treating neuroimmunological diseases at the VA Level of information: Intermediate