Re: Small Fiber Neuropathy

Posted By Penny on December 05, 1998 at 21:43:54:

In Reply to: Re: Small Fiber Neuropathy posted by CCF neuro MD MM on December 05, 1998 at 14:13:43:






Dear doctors,
Thanks for this forum it is a wonderful service.  Just a very few quick questions.  
1. Does Mild small fiber sensory neuropathy resolve in time?
2. If EMG STUDIES only detect Electrical things and can show mild Pn on the study, can it also evaluate the severity of small fiber neuropathy that is primarily sensory.  That is if your EMg showed a slight mild snapped latency does it mean you have a mild condition when its sensory and effecting the small fiber nerves.  Or does it mean the EMG can't pick up how severe the small fiber sensory nerve damage may really be?
3. I was told small fiber nerves below the skin are like branches so how long in a mild case is a guess of regeneration time.
4. Any treatments currently being offered to stimulate nerve growth or regeneration in small fiber neuropathy.



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: The ultimate outcome of small fiber sensory neuropathy depends not on the location or length of the fibers but on the underlying cause.
Unfortunately just because the problem is minor does not mean that it is going to resolve automatically without the precipitating cause being removed, if no obvious cause is identified then there is no way to predict if, how, or when it will resolve.
Regeneration in this case is totally unpredictable and does not proceed in the relatively predictable fashion that occurrrs in cases of straightforward nerve trauma or injury.
There are no nerve regeneration therapies available at this stage.
EMG is not very good at evaluation of small fiber sensory neuropathy, we are lucky if it shows any diagnostic changes whatsoever, so precise estimation of the degree of damage is difficult to quantify.
Thank you.  Wish we knew the precipitating cause. My first Neurologist felt I had a neurotoxic reaction to a drug as I had an adverse reaction and was treated for it when this began.  We ruled out assorted other causes all neg.  My Second neurologist said there is no evaluating small fiber neuropathies.  I had sensory and emg studies done.  So what if any are more diagnostic tools for small fiber damage.  If alot of small fiber damage is not picked up on EMG's does that mean when it does show as in my case that it is more severe , even though the EMg reports Mild. My condition is full body. Any suggestions for me?