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How do doctors determine SFN is NOT ALS or MS?
Neuropathy | Last Active: Mar 19 8:36am | Replies (15)Comment receiving replies
Hi, From what you report from your testing, the neuropathy seems to be associated with specific spinal nerve roots being compressed. Is your concern arising from symptoms you're having? When our spinal nerves are compressed, they can cause radiculopathy. Those symptoms can easily cause muscle weakness as well as a range of sensory and pain symptoms. Can you say why the podiatrist did the biopsy? Do you also have diabetes? It would not be uncommon for a diabetic patient to acquire a small nerve fiber neuropathy particularly in their feet. When I've had NCS & muscle stimulation tests, I had no nerve compression on-going. It specifically pointed out a different condition which was clearly labeled on the report as a different type of neuropathy. Mine was related to the myelin sheath around the nerves being destroyed. But it was not MS and certainly not ALS. My point being there is a wide range of disorders related to nerves and even with noted disease, the odds of it being some that you fear most are extremely low especially given how your report read. I hope you don't worry too much and I wish you the best.
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@sb4ca THANK YOU! Reassuring words mean a lot! I've always been a glass half-empty type, so I tend to go to the worst-case scenario. I am not diabetic. A friend had seen the same podiatrist I was seeing for foot pain. The podiatrist told her she did not think the pain was coming from her foot, but from her back. She referred her for an EMG and it was found that she had nerve compression at L4/L5. She had a fusion, and that solved her foot problem. I saw the same podiatrist for an issue with a toe injury, and after my friend shared her story, I saw the podiatrist again and asked if she could do the skin biopsy and refer me for an EMG... because I had been waiting and waiting to get an appointment with a neurologist... with no luck. The podiatrist did the skin biopsy after I described my foot numbness and burning/tingling. She referred me for the EMG to see if I may still be having some nerve issues in my lower spine that were affecting my feet. I had a 4-level laminectomy L2 - S1 in Nov 2022. It was afterwards that I began to notice the numbness and tingling. All I can make out from the EMG report is that there is still some sort of ongoing issue with the nerves in my lumbar area... perhaps foramenal stenosis or spondylolisthesis. Perhaps, as you say, there is some radiculopathy. My spine surgeon has suggested that a fusion of L4/5/S1 may resolve the issues with my feet... but he is not a neurosurgeon, but an orthopedic spine surgeon and, of course, he can make no guarantee. I do FINALLY have an appointment with a neurophysiologist next week, and I'm hoping that since neurology is his foundation he may be able to guide me further. Though I was pleased the podiatrist agreed to do the skin biopsy and send me for the EMG, she could share with me the reports, but said I needed to see a neurologist for further answers to my questions. She did prescribe Metanx for me, which I took for four months. Two weeks ago my PCP did blood work and included a re-check of my B6 vitamin levels, which were in the normal range six months ago, but came back as too high. So I have now stopped taking the Metanx. I just really feel I need the guidance from neurology.... but it has been SO difficult to get in to see someone. I'm sorry.... I didn't mean to go on and on... enough whining. But I did SO appreciate you taking the time to reach out and offer some comforting words!! Thanks again! Best wishes! Mike