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Small Fiber Neuropathy

  : : 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.
  : =================================================================
  : 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?
When nothing shows up on EMG tests it can mean that the person is anywhere from completely normal to severly impaired, when SOMETHING shows up the fact that the damage is present is at least proven but the extent of the undelrying damage does not necessarily correlate.
The tests are so variable that some responsed are completely absent in normal people, we cannot read any more into the tests you have already had.
There is a type of testing called qualitative sensory testing which is a specialized technique not perfromed by all labs which is better at asessing smallmfiber neuropathy.
I suggest that you ask the person who performed the test if this was part of the protocol, (it is not routinely available outside specialty labs so it may not have been done ). If this was not done you may wish to be referred to a center which can perform this technique. At this stage, without further assessment there is no way to answer your questions regarding the extent of the problem.
Even if you have this specialized testing, the condition is so difficult to assess that unfortunately futher information may not be generated.

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