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Old 05-30-2012, 08:52 AM   #1
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neuropathy diagnosis in question

I was diagnosed with peripheral neuropathy last month with a nerve conduction study. It was definitive. i went to a podiatrist today, and he said it was not definitive, that I had to have a nerve biospy, that then it would be definitive. I just read that a nerve biopsy is pretty invasive, and not neecessarily definitive. My symptoms are: numb, tingling, shooting pain in my feet, as well as a dull ache in my feet, severe muscle weakness in my legs. I have a lot of trouble walking, and use a cane. My question is: what should I do? I really don't want (nor think it is a good idea) to have a nerve biopsy. I am quite sure I have neuropathy, and have been daignosed to have it. What should I do?

 
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Old 05-30-2012, 01:48 PM   #2
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Re: neuropathy diagnosis in question

Were you diagnosised by a neurologist? Nerve conduction study's show positive when you have neuropathy. A sural nerve biopsy is very invasive and used to be the gold standard in defining neuropathy or vasculitis. Today they are falling out of popularity. Yes, I have had a sural nerve biopsy and they did not diagnosis neuropathy until I had a NCS/EMS, go figure. I personally would speak to my neurologist and see if he has anyone else to send you to or if he will speak to your podiatrist.

 
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Old 05-30-2012, 11:08 PM   #3
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Re: neuropathy diagnosis in question

Hi Sands819 - Sounds like your podiatrist is talking out of his field and beyond his expertise. If the nerve conduction study showed you have neuropathy, then you have neuropathy, and it is the type of neuropathy that affects your long fiber nerves. There would be no need to have a sural nerve biopsy in your case. This type of biopsy is used to diagnose small fiber neuropathy because that type of neuropathy doesn't show up on a nerve conduction study. The biopsy is also invasive and can have long lasting negative effects. Good luck to you. - Ruby

 
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Old 05-31-2012, 05:18 AM   #4
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Re: neuropathy diagnosis in question

How is peripheral neuropathy treated? I have an appointment with a neurologist next week to determine my problem. I have had a nerve problem in ball of foot for over 4 years following mortons neuroma surgery, and have went to countless podiatrists as well as an acupuncture dr. trying to get help. I'm hoping the neurologist will be able to determine my problem. I'm just not sure how they treat neuropathy if that's what it turns out to be.

 
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Old 05-31-2012, 08:16 PM   #5
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Re: neuropathy diagnosis in question

Hi Sands819. I had a sural nerve biopsy to determind what type of neuropathy I have as I had 3 EMG & 3 nerve conduction tests that showed up normal. The 3 Neurologists said that I have idiopathic neuropathy. Then I had a sural nerve biopsy that said "Changes suggestive of low grade small vessel vasculitis with focal loss of axons." This was interpreted as non systemic vascultic neuropathy. I then had a 4th very painful nerve conduction test that confirmed it as well. Without the sural nerve biopsy & a very smart Dr. I would have not known this. The surgery was quick but I asked to be put out. I have a ugly scar and the ends of the nerve are shooting off electrical shocks. It happenes without notice, but they get less severe as time goes on. I had my surgery February 27/12. I have all the same symptoms as you do, I need a cane & walking is painful. I go for IVIG treatments and that is another story I post about. Best of luck, its a big decision that I struggled with. For me since I started this journey I felt I needed to keep going & investigate until I could go no further. Hoping you have a your answers. June

 
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