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Are EMG and nerve biopsy tests necessary year after year?
Neuropathy | Last Active: Oct 10, 2023 | Replies (13)Comment receiving replies
I've had neuropathy for 3 years. I had the nerve conduction early which diagnosed this. The neurologist was reluctant to do biopsies but my PCP pushed. It was helpful to know areas of involvement. I haven't asked for more. I know it's getting progressively worse but I continue to have a great life with meds. I can see why docs don't wanna give more tests AND I also get why some monitor. Tracing progress may help with validating a patient statement and then changes to treatment. In my case symptoms were occurring outside of the bodily area where testing was done - mid back burning. I may ask to be tested again but just don't feel the need. My new neurologist and I work together to create plans to alleviate pain. She's a good. Great topic to bring up!
Replies to "I've had neuropathy for 3 years. I had the nerve conduction early which diagnosed this. The..."
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This is a great question, and the answer applies to most other diseases that are chronic, the cause is unknown and have no "cure".
I have idiopathic small fiber PN, meaning the cause is unknown. The only treatment is for my symptoms (pain). Other types of PN can be treated more specifically (diabetes, B12 deficiency, etc.) because the cause is known. The treatment is for the underlying cause.
In my case (and others) the diagnosis is assumed from the results of the EMG/NCS, blood tests, etc., which is typically normal in small fiber PN. My neurologist wasn't enthusiastic about a biopsy, but I insisted, just because I wanted to "know for sure". It was done, and it confirmed the diagnosis. I insisted because of the reasons noted above in other posts, but in the end, I gained nothing useful from the biopsy in treating the disease.
As in the cases described in the posts above, there is no need to repeat the tests, because now that the diagnosis is known, there is nothing new to be learned from repeat tests, and thus far, there are no new treatments. As far as progression (getting worse), that is determined from your symptoms; the tests can confirm that you are getting worse, but you already know that.
I am not generally in favor of doing tests simply to "know" something for which there is no corresponding treatment. After all, there is a downside to the testing (it can be uncomfortable, expensive, time consuming and even lead to complications and false results).
Regarding amputation, that is a result of chronic wounds, usually from diabetes. Further testing for peripheral neuropathy when that is also due to diabetes will not prevent you from getting foot ulcers. Treating the underlying diabetes is the answer