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Update on Whitney's skin biopsy

Jun 24, 2010 - 3 comments
Tags:

small fiber neuropathy

,

skin biopsy

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pediatric



Whitney had her skin biopsy on Tuesday.  The skin biopsy is done to test for small fiber neuropathy.  The procedure was done at Dr. Kinsella's office in Fenton, MO.  (Nice new office BTW).  Dr. Kinsella was GREAT with Whitney.  I wish he would also treat children, not just do the testing for pediatric neurologists.  

So the procedure is this: clean the areas (two areas: upper thigh and lower calf on one leg); swab with betadyne, and then inject with lidocaine. This is the part when Whitney cried a little because of the burning.  They then take a 3mm core biopsy from each site.  Then put a band-aid on each site.  Done in 5 minutes!  Dr. Kinsella will have the results in 10 days and then send it to Whitney's neurologist, Dr. Vashist.  Who I will then have to call and call and call to get results...

I have been reading more about skin biopsy and small fiber neuropathy.  It seems that not a lot of children get it but teens and older do, but mainly older folks and diabetics. The biopsy is done to confirm a diagnosis of SFN. There are some treatable causes of SFN (such as if you have Sjogren syndrome or vitamin b12 deficiency, or diabetes or impaired glucose tolerance.  About half of the cases of SFN are idiopathic.  Most people with neuropathic pain are treated with gabapentin, Lyrica, or Cymbalta and other anti-seizure and anitdepressants.  Whitney failed a trial of gabapentin and is on Lyrica and Nortriptyline (and they aren't helping either).  I also read that many patients with SFN will not tolerate or will not get relief from those medications....great...I hope these kick in...soon...the next lline defence seems to be sustained-relief opiates. I do not want to go there...at all...



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by CHRISTYDRAKE, Jun 24, 2010
Cody was diagnosed with small fiber neuropathy based on the thermoregulartory sweat test(the one I posted pictures of).  He has no pain associated with it though.  His legs sweat just fine though, so if they would have done a skin biopsy of just his legs, his would have come back fine.  It is his entire midsection that has the problem.  I don't fully understand SFN, he is not being treated for it as far as I know, unless his medication is pulling double duty for that and his other symptoms??

I hope they find a medication to help her, having a child in pain is heartwrenching.(plus all of the other symptoms to boot!!)

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by LA1989, Jun 24, 2010
Sounds like quite a day! I hope her meds kick in, too. Poor thing. :(

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by tdavidson, Jun 24, 2010
I don't understand it all either, but I just printed out some journal articles to read about it instead of just patient websites.  Since I read scientific journal articles all the time for work, I am hoping I can understand at least part of it!!!
LOL



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