@johnbishop Would you say that sfpn is a form of pn?

Hi Jim @jimhd, I had always thought of small fiber peripheral neuropathy (SFPN) is the same as peripheral neuropathy (PN}. But it can actually be either small or large fiber nerves.
https://neuropathycommons.org/neuropathy/neuropathy-overview

That is an excellent link!

Since being diagnosed (only a few months ago!) I've thought of PN as being the overarching term for the disease, with the various types of PN falling underneath.

I thought SFP was "Small Fiber Polyneuropathy"…a special form of SFN which progresses in a socking and glove fashion from usually the feet upward…I just had a second skin biopsy for this condition…Pam @burningfeetinphoenix

@burningfeetinphoenix If you don’t mind me asking, did you get your results back from your second biopsy?

@katec Results of second biopsy showed I did not have SFPN! What a surprise. After my podiatrist indicated my biopsy said I has essentially no small fiber nerves left in my epidermis. He wanted to give me stem cell injections for $2,500.00 each and no insurance coverage…something's wrong here…all ENFD results were negative for SFN. Pam

Wow, that’s amazing news!! I’m so happy for you and hopeful for the rest of us!! Does your dr think it has anything to do with the meds you were on? Have you only ever been on the phenytoin?

@katec I've been on the Phenytoin cream and 30 mg Cymbalta for several months. I am reluctant to stop. See Dr Levine in Feb. Will decide then what to do. The burning feet this summer was excrusiating. I lost three months of my life. Not sure what to think…Pam

@burningfeetinphoenix – we may need a doctor to chime in and provide clarification on the medical terminology and differences (@jeffrapp?), but when I look up polyneuropathy – it pretty much describes my situation and I was diagnosed with Small Fibre Neuropathy. In fact, I told my doctor that I always experienced pain on both sides of my body at the same time – which seemed bizarre to me. I NEVER felt pain in only one foot or one calf – the pain was always 'mirrored'…
https://en.wikipedia.org/wiki/Polyneuropathy

My diagnosis is Axonal Sensory Neuropathy (unknown cause). I also experience pain and burning on both sides, sometimes it feels like a little more on one side than the other. Peggy

👍🏼

@burningfeetinphoenix

Are you getting the same diagnosis and treatment from more than one doctor? If I were in your position I would be asking my doctor to recommend a specialist to give a second or third opinion. That's something my own doctor is happy to do.

I just read an article about this very subject, and the writer said that doctors are asked to refer the patient regularly and should have no problem with it. If you can access the AARP magazine that just came out, it's "The Art of Getting a Good Second Opinion", by Kimberly Rae Miller. It's a great article.

Jim

@iceblue, I'll give it a try. This is a very complex and confusing subject.
The terms polyneuropathy, peripheral neuropathy, and neuropathy are often used interchangeably, but there is a difference. Polyneuropathy is more specific, and refers to a set of diseases characterized by multiple, often symmetrical nerve involvement. Peripheral neuropathy is more general, and can involve only one nerve, such as trigeminal neuralgia. Neuropathy is more general still, and can even mean involvement of the central nervous system.
Small fiber peripheral neuropathy is a form of polyneuropathy which refers specifically to the small fibers in the skin. This is the condition usually diagnosed with an epidermal nerve fiber density test (EFND), the "skin biopsy" often referred to here.
@burningfeetinphoenix, I don't quite understand your post about the podiatrist. If your skin biopsy was positive, then you do have small fiber peripheral neuropathy (SFPN). One way or another, I'd be careful about dealing with this podiatrist, as there is no evidence as yet that stem cells have a roll in treating any neuropathy.

@burningfeetinphoenix I second what @jeffrapp said about being careful with the podiatrist for the same reason – I have not read about any evidence or clinical trials for treating neuropathy other than one for treating diabetic neuropathy and I think the jury may still be out on the treatment.

Mesenchymal stem cells to treat diabetic neuropathy: a long and strenuous way from bench to the clinic
— https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4979500/

Here are a couple of sites with negative implications for stem cell treatment for neuropathy.

Canada case highlights possible long-term risks of experimental stem cell therapy
— https://www.statnews.com/2019/07/11/canada-case-long-term-risks-experimental-stem-cell-therapy/

FDA Warns About Stem Cell Therapies
— https://www.fda.gov/consumers/consumer-updates/fda-warns-about-stem-cell-therapies

My pain management doctor texted me the following when I asked about regenerative medicine:
There's better stuff, stem cells are not very viable when you put them from one place to another. Look up exosomes.