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Epidermal nerve fiber Density Test

Neuropathy | Last Active: Feb 6, 2019 | Replies (4)

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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

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

Hi ElaineD @elained, Thank you for the kind words. I really have no medical background or training. I have not had a skin biopsy either. My Mayo neurologist diagnosed my idiopathic small fiber peripheral neuropathy with an EMG, MRI and some blood work...can't remember all the details. I was kind of devastated that there were no drugs, etc. that would help my numbness. If it were me, I would not get a skin biopsy just to confirm what I already know I have. The only thing it would offer is peace of mind but I guess that can sometimes be comforting. The only thing that has been somewhat helpful for me are the supplements I take that I found in a closed Facebook group (http://solutions2pnpd.com/). I was pretty skeptical at first as everyone should be but listening to the success stories of other members in the group gave me some hope. I know the drugs work for a lot of people but I'm happy I found an alternative. The drugs really don't fix anything...they just block the pain. I'm still hoping they break the code for stem cell therapy for peripheral neuropathy.

Hope you find some answers that help!