Other Neuropathy types - Neuropathy Message Board

faris1877 · 03-11-2008, 01:41 PM

Hi All,
I was recently referred to a neurologist for a tingling/stinging in my heels and buzzing in the front of my heels/back of the arch of my feet. These sensations almost always come up before going to bed or after exercise. I never really have any discomfort while walking, running, or biking and go several days without discomfort at a time. Occasionally (maybe a couple times a month) after excercise and sometimes as i'm trying to sleep, the top of my feet, close to the toes begin to feel hot making me either take my shoes of or walk around on cold tiles.
The neurologist did a full physical exam and did EMG and nerve conductance tests and said all was normal except I had diminished reflexes in my lower extremities (something I believe has been noticed by other doctors before). I asked him explicitly and he said there is no evidence that I have any neuropathy. He put me on a trial of medication for restless leg syndrome. Regardless, I'm going in for a full blood workup tomorrow (B12, thyroid, ferretin, RPR).
My question is, with all his assurances, could this still be a type of neurapathy? I've read online the the small fiber type does not show up in an EMG or NCS. Do my symptoms suggest that type of neuropathy? Any help or advice would be greatly appreciated!
Thanks and good luck to everyone.

Aussie100 · 03-13-2008, 12:03 AM

Quote:

Originally Posted by faris1877

Hi All,
I was recently referred to a neurologist for a tingling/stinging in my heels and buzzing in the front of my heels/back of the arch of my feet. These sensations almost always come up before going to bed or after exercise. I never really have any discomfort while walking, running, or biking and go several days without discomfort at a time. Occasionally (maybe a couple times a month) after excercise and sometimes as i'm trying to sleep, the top of my feet, close to the toes begin to feel hot making me either take my shoes of or walk around on cold tiles.
The neurologist did a full physical exam and did EMG and nerve conductance tests and said all was normal except I had diminished reflexes in my lower extremities (something I believe has been noticed by other doctors before). I asked him explicitly and he said there is no evidence that I have any neuropathy. He put me on a trial of medication for restless leg syndrome. Regardless, I'm going in for a full blood workup tomorrow (B12, thyroid, ferretin, RPR).
My question is, with all his assurances, could this still be a type of neurapathy? I've read online the the small fiber type does not show up in an EMG or NCS. Do my symptoms suggest that type of neuropathy? Any help or advice would be greatly appreciated!
Thanks and good luck to everyone.

Hi, the small fibre nerves are the ones that responsible for sense of feeling
[heat,cold & pain] you would need Quanitive Sensory testing or a skin punch biopsy to confirm small fibre damage, QS testing also tests the large nerve endings as they are responsible for sensing vibration, your right, a NCtest or an EMG test for large nerve function only.
In the early days of my neuropathy i had an idiot professor of neurology do a nerve conduction test on me and he wrote back to my doctor saying that i showed no signs of peripheral neuropathy, luckily the next neuro knew what he was doing and laughed at the others report, i hope you find a good neuro.
good luck anyway,
Aussie

faris1877 · 03-13-2008, 07:49 AM

thank you for your response, aussie.
I'm wondering if he ruled out small fiber neuropathy because of my symptoms? Can anyone tell me what the symptoms feel like and how often you feel them? Is it a pain,cold,or hot feeling all the time or is it an inability to recognize temperature and pain?

anwise67 · 03-13-2008, 08:33 AM

hi faris. I was dx with small fiber neuropathy thru a epidermal biopsy after 2 long years of trying to find an answer. My symptoms began to appear over 4 years ago. At first I only had problems after exercising(walking 2 miles). My feet would get really red, burn, and the veins would pop up. Other symptoms that I had were; muscle twitches, cramps, numbness(stocking-glove distribution) in arms and legs,numbness in face,tingling,and electrical shock sensations, sensitivity to touch. I think what really got me to the diagnosis was a realization that I could not differentiate b/w hot and cold below my knees. I saw 4 neurologist before i found one who finally got it. I hope you find an answer soon.

faris1877 · 03-13-2008, 08:58 AM

thank you anwise. Although my symptoms come up after exercise, they sound a bit different than what you've experienced. Are those typical of SFN? I do feel the tingling and occasionally stinging but never really pain. Only on rare occasions i feel something like burning. From experience, I can tell the difference between cold and hot. I've never had any numbness though. Are these symptoms you've described "defining" SFN symptoms? Did you ever find out what caused you SFN?