Testing for Neuropathy

Posted by klro0001 @klro0001, Jan 17 12:19pm

Greetings, everyone. I hope this new year is going as well as can be for all of you. I was wondering if a few of you wouldn’t mind sharing your experience with getting tested for neuropathy. I went to a neurology appointment on yesterday and requested blood tests and a skin punch biopsy. I was told that I had to undergo 3 MRIs first and they refuse to act on my request before this is taken care of. Did any of you have to do MRIs before blood tests? I would appreciate any insight or feedback that you guys have. Thanks so much for your support and your time.

Never had an MRI for anything related to my PN. Nerve conduction tests were what verified my PN.
Tests done through a neurologist.

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I was told the opposite. My last 3 MRIs I had to do the blood work before the MRI, which the last one was earlier this week.

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I never had an MRI either although a podiatrist mentioned getting one. My neurologist confirmed SFPN, and he and my internist ordered blood work which confirmed there was no underlying disease, and suggest mine is idiopathic. No one ordered an MRI. Sorry you are having such a run around.

Liked by klro0001

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Hi @klro0001, I had an MRI before I was able to meet my neurologist at the Mayo Clinic where I was diagnosed with idiopathic small fiber PN. The MRI is not a test for peripheral neuropathy, but is performed to exclude other disorders that produce similar symptoms.

Peripheral neuropathy – Diagnosis & Treatment
https://www.mayoclinic.org/diseases-conditions/peripheral-neuropathy/diagnosis-treatment/drc-20352067

This short video by Matthew B Jensen Assistant Professor of Neurology, University of Wisconsin that gives a good explanation of how the different neuropathies are diagnosed.

Liked by phoenix0509

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I understand the purpose of the MRI and the need to exclude other conditions. However, I can’t understand why a simple blood test and biopsy can’t happen first. In fact, I didn’t even meet the neurologist. My appointment was with his physician’s assistant. I just don’t want to pay the astronomical insurance deductible if it’s not absolutely necessary.

Liked by rwinney

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@klro0001

I understand the purpose of the MRI and the need to exclude other conditions. However, I can’t understand why a simple blood test and biopsy can’t happen first. In fact, I didn’t even meet the neurologist. My appointment was with his physician’s assistant. I just don’t want to pay the astronomical insurance deductible if it’s not absolutely necessary.

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I had a blood test prior to the MRI and meeting with the neurologist. I'm guessing a biopsy is not really as simple as a blood test but I have no medical background or training so don't really know the reasons. Can you seek a second opinion or help from another doctor or neurologist?

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@johnbishop

Interestingly, this neurologist was supposed to be my second opinion. Lol. But, I have to advocate for myself so I am down for trying for a third. Thanks for your help and your advice.

Kia

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kiro0001 Hi Kia, Never heard of MRI's first, but I could see it if docs really do suspect something besides the neuropathy. I don't think this has to be the order in which to do these tests in, though. I hope you are OK? Lori Renee

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@lorirenee1

Thanks so much for inquiring, Lori. I hope you are still doing better. I’m fine, physically. I’m just extremely discouraged and annoyed. Before this, I never had bad experiences with finding doctors that listened to me, stayed in my corner. And came up with a game plan that we both could agreed with. The PA said that their clinic’s first step is always to rule out MS so the 3 MRIs are “medically necessary.” The scans would take more than two hours so I would need to book them over two appointments (and the two appointments are over a 4 week period). Also, When asked what the next step would be if my MRIs were clean, I was told, “Let’s just cross that bridge when we get to it.” Something about this didn’t sit well with me. And this clinic has their own MRI machines so a small part of me thinks they may be more motivated by money than patient care. And I don’t want to be just a number to someone treating me. Sorry for the rant. I will put my big girl pants on and keep searching.

Kia

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Interesting that they say they rule out MS first. Because MS is usually diagnosed by ruling everything else out first. I had an MRI first, and it even showed lesions, but further testing hasn’t shown a for sure diagnosis of MS or anything else for that matter. I have ruled out a whole bunch of things, through bloodwork, 3 EMGs, spinal tap, skin biopsy, etc so those tests are valid for finding a source of neuropathy and at least some of them are cheaper than MRIs (I don’t remember all of the costs). I hope you can get a good second opinion. There are so many things that can cause neuropathy – some are pretty easy to find and don’t need a MRI. Good luck!

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@jair19

Interesting that they say they rule out MS first. Because MS is usually diagnosed by ruling everything else out first. I had an MRI first, and it even showed lesions, but further testing hasn’t shown a for sure diagnosis of MS or anything else for that matter. I have ruled out a whole bunch of things, through bloodwork, 3 EMGs, spinal tap, skin biopsy, etc so those tests are valid for finding a source of neuropathy and at least some of them are cheaper than MRIs (I don’t remember all of the costs). I hope you can get a good second opinion. There are so many things that can cause neuropathy – some are pretty easy to find and don’t need a MRI. Good luck!

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@jair19

Thank you for sharing your experience. I really appreciate it.

Kia

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Hi @kiro0001, you requested some feedback about the neuropathy test procedures that we have experienced personally. So, here you go:
1. EMG and nerve conduction.
2. Blood tests
3. MRI
4. Auto-immune tests
5. Skin punch biopsy
6. Neuropsychological tests

I do think that my neurologist was most interested in getting the MRI done before the medication could be prescribed. Because the dosages are graduated, he didn't want to start on something until all the results were in. He did give in on gabapentin…..my pain level was too high not to get some relief going. What has your sequence been, how was it different? Have a day free of suffering. Chris

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Can you share what type of MRI? Brain? Spinal? It seems reasonable to undertake brain and spinal MRIs.

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Brain, spinal and one more that I can’t remember right now.

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@artscaping

Hi @kiro0001, you requested some feedback about the neuropathy test procedures that we have experienced personally. So, here you go:
1. EMG and nerve conduction.
2. Blood tests
3. MRI
4. Auto-immune tests
5. Skin punch biopsy
6. Neuropsychological tests

I do think that my neurologist was most interested in getting the MRI done before the medication could be prescribed. Because the dosages are graduated, he didn't want to start on something until all the results were in. He did give in on gabapentin…..my pain level was too high not to get some relief going. What has your sequence been, how was it different? Have a day free of suffering. Chris

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@artscaping

Thank you for sharing your experience. So far, I’ve only had EMG and NCS. The NCS showed damage in my left leg. I haven’t gotten past this point yet. I’m not in pain, so I don’t think the PA took me very seriously. In fact, she said, “You definitely don’t have neuropathy because your symptoms aren’t in your feet and you’re not burning.” I know from my own research and speaking with all of you that neuropathy doesn’t follow any rule book. What type of MRI did your doctor order, Chris?

Kia

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