@jyoung1963
The small fiber neuropathy biopsy is the gold standard test and you don’t need to have another test. EMGs/nerve conduction studies and cervical spine MRIs can be done anytime a doctor needs new/updated information to help them diagnose and treat you, especially as your symptoms evolve/change over time. I have had EMGs 2017, 2019, 2024 and 2025 and had cervical MRIs 2017, 2019, 2022, 2023, and 2024. I may need an updated MRI in 2025 before my surgery.

Small fiber neuropathy can affect a lot and cause many symptoms. It affects sensory and autonomic nervous system. It is important to keep an eye on bloodwork for glucose levels, A1C, vitamin deficiencies or toxicities, eliminate alcohol/toxin exposures, etc. to prevent worsening. It is also good to make sure iron levels and oxygen levels are good and you get exercise to ensure good circulation.

1. https://my.clevelandclinic.org/health/diseases/17479-small-fiber-neuropathy
2. https://www.hopkinsmedicine.org/neurology-neurosurgery/specialty-areas/peripheral-nerve/small-fiber-sensory-neuropathy
3. https://www.healthline.com/health/small-fiber-neuropathy
4. https://www.health.harvard.edu/diseases-and-conditions/the-big-pain-of-small-fiber-neuropathy
5. https://www.mayoclinic.org/diseases-conditions/peripheral-neuropathy/diagnosis-treatment/drc-20352067
6. https://ce.mayo.edu/sites/default/files/media/2023-10/16-Rubin_PeripheralNeuropathyNEW_7-12-23.pdf