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Neurology (Expert Forum)
small fiber neuropathy/autonomic disorders
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small fiber neuropathy/autonomic disorders
by nancyd, Dec 10, 2001 12:00AM
Hi, I am a 44 yr old female who has been having strange symptoms for about 5 years. I am otherwise healthy with stable mood and stable life. They include dizziness, muscle twitching; constant tinnitus; muscle fatigue; ice cold burning/tingling and sensation that I'm sweating (but I'm not) especially on face, chest, arms, and legs; headaches; and palpitations at times. These symptoms occur 3-5 days of the week and last the entire day and if I'm lucky I can sleep it away for a while. I have seen several doctors and have been given dx such as atypical migraine, chronic fatigue, vestibular neuritis and deconditioned . MRI's,EEG, EKG and bloodwork have been normal. ENG and balance tests initially abnormal but normal as time has progressed. Recently saw a new doc (neuro) who thinks the problem might be small fiber neuropathy. The doctor has recently prescribed Corgard, Catapres, and Imiprimine. I think it may be helping lessen the symptoms but it's a little soon to tell yet. I have been scheduled for tilt table test and other autonomic testing as well as EMG. I'm wondering if you are familiar at all with and could discuss small fiber neuropathy or autonomic disorders and the testing that relates. Do my symptoms sound as if they could fit into such a diagnosis? Are you aware of any other dx that may apply. I appreciate any input you might have to offer. Thanks for your wonderful service.
Nancy
Nancy
Doctor's Answer
by CCF-Neuro-M.D.-JT, Dec 13, 2001 12:00AM
Routine lab tests should have been done including thyroid testing to make sure all treatable medical conditions have been properly ruled out. If you are having palpitations, extended rhythm monitoring may be indicated as an EKG can sometimes miss cardiac rhythm problems as it is merely a snapshot of one instant in time. Autonomic disorders are also a possibility as you describe some kind of sweating sensation and palpitations, alkthough it is not the typical presentation. The workup sounds fine. An uncommon disorder that has been gaining recent attention is mitochondrial disease. The mitochondria are the power cells of your body that can lead to a complicated medical picture with various symptoms if abnormal. SOme syndromes are manifested as hearing loss, muscle aches/weakness, and cardiac problems. They are evaluated with serum and urine amino acids, lactic acid, pyruvate levels, and most definitively by muscle biopsy. Talk to your doc to see if that's a possibility. Unfortunately, I haven't seen you personally, so it's a bit of a shot in the dark based solely on your reported symptoms. GOod luck.
Your symptoms sound almost identical to mine which i've had for about 6 months now. I've had routine bloodwork done and thyroid, B12 and everything has come back normal. If you'd or anyone else with these symptoms would like to discuss them please e-mail me at ***@****. I'd really appreciate it !
my name is sherald Bridgeman...MY Mother is 56 and is in hospital at the moment, The Doctors have told her she HAS smallfiber neuropathy... Like you she has a burning pain and all the other thing you said... she has been very unwell for the past 6 months they have done every test on earth to find out what it is but came up with nothing.... Monday the 25th of feb they took her in to hospital and yesterday the 2and of march they told her what she had.....Now i am here trying to find out what it is and how it is treated, and i thought i would write and tell you....my e mail address is ***@**** if you want to keep in touch..
Take care
sherald