My neurologist is reluctant to do the skin biopsy because the results wouldn't change the treatment plan. I think it would be helpful to have the skin biopsy to verify the diagnosis and to have a baseline.
I am able to group the symptoms into two groups.
The benign fasciculation syndrome symptoms occur mostly as I drift off to sleep, Twitches/pops occur in different areas of my body, occasionally initiating movement. The BFS symptoms occur, less frequently, when I am idle, but never initiate movement. The episodes don't occur every night or every time I am idle. If I initiate movement, the symptoms stop.
The small fiber neuropathy symptoms occur throughout the day and may wake me at night. One symptom is burning in my hands and feet. This happens, largely, when I have been using my hands to drive long distances or my feet to walk long periods. A second symptom is electric pulsations occurring on my arms, hands, lower abdomen (very rare,) legs, and feet. I may feel pulsating zaps of electricity down one finger or electric zaps that feel like a buzzing swarm of bees between my toes. (I am not sure how else to describe the sensation.) A third symptom is the feeling that I am walking on sand when walking on hard surfaces. This sensation may be contained to a small toe or cover the complete bottom of a foot. These events are not simultaneous. I haven't identified a variable that causes it to get worse or improve, except the gabapentin seems to decrease the frequency of occurrence, the longevity and the intensity.