Small Fiber Neuropathy or BFS?

Information about how to manage or reduce the severity of BFS symptoms

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Small Fiber Neuropathy or BFS?

Postby twitchfellow on March 22nd, 2011, 1:55 pm

There has been some discussion lately about whether the tingling symptoms BFS sufferers experience in their feet, legs and hands may instead be related to small fiber neuropathy.

I had a biopsy in 2009 to measure the epidermal nerve density in my lower calf and my thigh. While my small fiber nerve density was quite normal at the thigh, the result at the distal end of my calf was "low normal," consistent with early SFN (small fiber neuropathy). My neurologist nevertheless diagnosed me with BFS after a normal EMG, adding that the low-normal epidermal nerve density could be attributable to my early diabetes (my endochrinologist, however, said my pre-diabetic state was not responsible for any neuropathy I might have, so go figure). My orthopedic surgeon ventured that the low-normal result could be attributed to the fact that I have suffered from long-standing nerve compression at the L5-S1 level of the lumbar region of my spine -- I definitely experience tingling in that same dermatome, especially when seated for too long. I think my tingling, at least as far as the feet and legs are concerned, is multifactorial. As for BFS, perhaps it contributes to loss of small fiber nerves in the same way fibromyalgia is thought to contribute to it. However, even if it does -- and who really knows? -- I am not concerned, especially given that small-fiber nerves are capable of regenerating. If a BFS sufferer is not diabetic or an alcoholic -- two main culprits when it comes to SFN -- then it's probably not worth getting overconcerned about SFN.

In any event, anyone who wants to pursue SFN diagnostically can go to a major medical center and get the biopsy (it's a breeze in comparison to a muscle biopsy). There is one main laboratory that tests epidermal nerve fiber density. It is called Therapath in New York City. http://www.therapath.com/
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Re: Small Fiber Neuropathy or BFS?

Postby raindog on March 22nd, 2011, 2:28 pm

I have a motor neuropathy, flat lower limb reflexes and a dirty emg. Think mine is more signifacant and will probably lead to a different diagnosis at some point.
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