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Old 11-19-2007, 10:15 AM   #1
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What is the point of a nerve biopsy?

I decided to see a new Dr.(neuro) in an attempt to get a dx as to why I have pn in both legs and feet and why I have Raynaud's, balance problems and some other symptoms. His first suggestion was a nerve biopsy which I thought was a bit extreme...I would think bloodwork, MRI, maybe even a spinal tap before going for a nerve biopsy. I have heard some stories about pain becoming worse afetr this procedure and it is invasive.When I asked him what that would dx he was vague.In other words...maybe nothing. I have had EMG studies and past bloodwork which showed an elevated protein. Other than that...an MRO showing another disk herniation(no relevance to where my pain is) and I do believe radiculopathy,and from what I have read can cause pn.Doesn't an EMG show where the nerve damage originates from? Also he made a strong point about HIV which I have been testedfor long ago due to transfusions from 1986.....I am married to the same man for 21 years. Any thoughts on what to ask him would be greatly appreciated. Thank you...Love, Sharonn

 
Old 11-20-2007, 06:14 AM   #2
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Re: What is the point of a nerve biopsy?

never actually had to have a nerve biopsy but i would tend to have to agree with you.there ARE better and less invasive ways of finding things out about nerves other than cutting into one and taking a piece of it.owie!just what exactly IS an MRO??never heard of that one before.where was that test done in reference to your spine,or i am assuming this was done on your spine?so you have never actually had a real MRI done on the low back?or any other place like the c spine either?your balance issues,are they more a gait issue or do you actually "feel" off in some way further up?

an EMG will only show direct nerve compression or heavy compromise or deterioration of some sort that actually is impedding nerve flow.that is what gets tested,the nerve flow thru a particular nerve.believe me,you can have alot of spinal issues with alot of real pain and still actually have a really good/normal EMG.this happened with my c spine years ago despite severe radiculopathy going on.my nerve was "intermittantly' becoming impinged not constantly so unless you are in the 'perfect' posistion that would actually compromise the nerve during the test,it could or would show normal flow.an EMG really isn;t the greatest test for certain diagnostics but great for others.it all depends on what the doc wants to know,ya know?an MRI with contrast at this point would be a good place to start.i certainly wouldn't put myself thru the hell of having a piece of nerve cut out when other testing could possibly show much more and not hurt or cause possible future pain issues.i think you are right in not going this route just yet.but thats just me.i would have a serious chat with your doc about doing the MRI and see what may or may not actually pop up.if he still wants to do the biopsy,honestly i would see another doc.i do wish you luck with this and hope you can find the cause here without having to undergo anything nasty.please keep me posted.Marcia
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3-22-01,herniated C-6-7
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

 
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Old 11-20-2007, 10:58 AM   #3
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Re: What is the point of a nerve biopsy?

Hello Sharonn. Truth is an EMG in the case of a peripheral neuropathy isn't specific for cause. Just tells you have a generalized nerve problem. Therefore, in some situations looking directly at a piece of nerve is useful. The nerve most commonly biopsied is the sural (a small sensory nerve in the foot) and the proceedure is quite benign. The loss of sensation is pretty slight. Though it sounds invasive it is minimally so. But by all means pin the neurologist down about what he's trying to accomplish with this. Good Luck..

 
Old 11-23-2007, 05:33 AM   #4
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Re: What is the point of a nerve biopsy?

Thanks guys...Ooops! Meant MRI....have no idea what an MRO is LOL!. I am even more perplexed because he sent my PCP a letter with no reference to a nerve biopsy but a bloodtest looking for Sarcoidosis and a spinal tap, He wants me to take Topamax but quite honestly I have been on it before and it did nothing but make me sleepy. Oxy and elavil are enough drugs, I am hallucinating on occasion surrounding sleep(as in waking up seeing and hearing things) and if I weren't on pain meds so long I would blame them. It hapens when I am real tired. Scary, eh? Thanks for the responses. Hope everyone had a nice Turkey Day. Love, S

 
Old 12-29-2007, 05:53 AM   #5
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Re: What is the point of a nerve biopsy?

I am bumping this up to the top because believe it or not...I never heard back from the neuro....I was there 11/14 and the last words from his nurse were"we'll call you as soon as we get your bloodwork and emg studies(DR. is 1/2 hour away) Surely by now they would have at least called me to schedule something or draw blood...I refuse to call.I am so over it. Borrowed 300. dollars for this visit..I will give it another month to see if they contact me. Now I have no confidence in this Dr. a they obviously took my $$ and forgot me. I have never heard of it taking this long. All he had to do is get a fax from my primary who has my EMG and MRI results. I know this sounds ludicrous.....but I am tempted to ask for my money back. I live on SSI and believe me it barely pays the rent. Thanks everyone for letting me vent. BTW...Happy Holidays to Everyone! Sharonn

 
Old 12-29-2007, 08:37 AM   #6
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Re: What is the point of a nerve biopsy?

just wondering here sharon,if you are actually on SSI,do you not have medicare?or are you just on ssD?how long have you been on it?after two years on SSD you should have gotten something to inform you that after that two year period,you DO now qualify for medicare.if you are actually on SSI,they should have informed you right away that you ARE eligible without that two year waiting period.just wondering.

honestly,i cannot believe you have waited THIS long for some answer back from these idiots.have you tried to contact them at all?i would actually call them and ask to have all of your medical records from them(you just have to sign a release that they send in the mail and you sign and send back to them,very simple)and move onto another,more caring neuro.this is just sick actually.i would at least call them and demand some answers after all this time,they DO owe you that much.thats just sick,really.you DO deserve much better than what you have been getting from these people.moving onto another doc,i really do think that would be your best bet right now for the best possible care.these people obviously don't care enough about their patients or you would have heard SOMETHING by now,ya know?these are not people i would want in charge of my healthcare at all,no way.they have proved that to you.they do not deserve your money or your time.too bad you cannot get that refund back from them since they did nothing for it but drive you insane with the huge wait for simple results.

i have to say,when this doc wanted to go right to an actual nerve biopsy,i kind of felt it was way too much too soon ya know?there are better ways of obtaining that type of info without going that route just yet.other things should be done FIRST,before going to the actual nerve biopsy.he just did not have any real basic info yet,if one is needed down the road then fine,but to do this right away was just a bit too quick for me.i personally would have just asked what other tests can we do first before doing that.this would have just naturally created some type of real nerve damage and once any nerve becomes damaged in any real way,there is no telling just how it could react or what it could create for you to have to deal with after,ya know?

sooo,obtain those records and for the best possible care here,move on to another neurosurgeon who gives a damn about their patients.you just deserve much better care than this.please keep me posted on what you find out,K? good luck hon,Marcia
__________________
3-22-01,herniated C-6-7
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

 
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