| Peripheral neuropathy, or the abnormal functioning of | | | | is a technique that allows the diagnosis of small fiber |
| a nerve in the feet or ankles is becoming increasingly | | | | neuropathy with 97% accuracy. This is the analysis |
| more prevalent in society. On a regular basis, I have | | | | of a 3mm punch biopsies of the skin to count the |
| individuals coming to our office to be evaluated for | | | | number of nerve fibers and compare to the usual |
| numbness, tingling, shooting pain, electrical shocks, | | | | number. Since the skin is quite consistent in this |
| feelings of cold, burning pain to the feet. Many of | | | | respect, the value can be compared to the standard |
| these individuals don't have diabetes (the most | | | | and confirm the presence of small fiber neuropathy. |
| common cause of neuropathy in the United States), | | | | No other test is as accurate for small fiber disease. |
| but still have the symptoms. They have neuropathy | | | | The other great advantage of epidermal nerve fiber |
| and often wonder how extensive it is our how many | | | | density testing is the ability to evaluate the |
| problems they may have from this neuropathy. | | | | improvement or regrowth of small nerve fibers after |
| Over the years, many tests have been developed to | | | | treatment is undergone for neuropathy. Comparing to |
| help evaluate the nerves. A nerve conduction test is | | | | the previous biopsy, treatments can be shown to be |
| useful and can help people evaluate the functioning of | | | | effective by more than just subjective measures. It |
| the larger nerves. These tests, however, may be | | | | doesn't just feel better, it really is better. This is of |
| inconclusive for small nerve fiber damage as often | | | | great value to showing the value of newer |
| seen in neuropathy. Vibration testing, light touch | | | | treatments to not just stop neuropathy symptoms |
| testing, temperature (hot-cold) testing and PSSD | | | | but hopefully reverse the progression. |
| testing have all also been utilized to help in this | | | | So as you suffer with your neuropathy and are told |
| respect. But they have varying results dependant on | | | | that you "probably" have neuropathy, this new test |
| the physician performing the tests. So the question | | | | may be a great opportunity to quantify the presence |
| usually is how a patient can get the best results or | | | | or absence of neuropathy. Then you can work with |
| best understanding of the extent of their disease | | | | a specialist to reverse these symptoms and return to |
| and more importantly how they can evaluate | | | | normal life. In other words, you can optimize what |
| improvements from various treatments. | | | | you were born with! |
| A newer test, Epidermal Nerve Fiber Density testing, | | | | |