Dear John, you are a fabulous resource and I really appreciate what you do for us.

I have a question about the Epidermal Tests for Small Fiber Neuropathy. Do the results of the biopsy determine the course of treatment?

I take 4200 mg of Gabapentin a day and still have SFN pain and itching especially in my lips and the tip of my tongue burns. But worst of my pain and discomfort are controlled.

I haven't had the skin biopsy, although my neurologist offered it, however he said that whatever it showed, wouldn't affect my treatment.

Am I right in thinking there's no need for the skin biopsy?

I am very realistic about the prognosis for my neuropathies. My feet and legs cannot get worse. However I started with damage to the nerves of my moisture producing system (2002) , and also have lung, ear, and bladder damage. This past year I was diagnosed with conditions stemming from neuropathies in my gastrointestinal system.

I am also very realistic about treatment options for my neuropathies. As far as I can tell the only treatments for neuropathic pain are anti-convulsants like Gabapentin and Lyrica, pain medications including Cymbalta and medical marijuana (which isn't available yet in North Carolina.)

Regards, ElaineD