I'm here to tell you that (following skin biopsies in my left leg) that I was dx'd with SFN at all three sample sites ...the upper calf, the lower thigh above knee and mid thigh. I found that mine was a result of glucose (not gluten) intolerance that I've probably had for some time. I researched SFN and found that in many cases it also involves the larger fibers (including autonomic and motor). I've also been told that I have EBV, fibro and bony protrubances / foraminal narrowing C5-6 if memory serves. All symptoms (twitching, burning, muscle fatigue, diminished reflexes (slightly) and (to my eyes) a negligible loss of muscle bulk, all on the left side). The twitches / fascics and fatigue began 18.5 years ago, and I've had previous bloodwork over the years with normal glucose, but the newer symptoms may very well be related to glucose levels (which accompanied a very high stress, sedentary job where it's always a pot luck or birthday party with never ending cake and snacks-- thank God I now work from home). I have a slightly weaker left foot which appears to have a circular indentation on the inside below ankle bone, yet I still walk fine, can stand on toes, and have no clinical deficits (no babinski). I'm getting older and have probably always had a weaker left foot/leg, but like most of us I'm hyper vigilant, so a mole hill becomes Mt Everest. I try to keep anxiety under control, and feel that I have a constellation of symptoms from different sources (SFN, anxiety, cervical damage, scoliosis, fibromyalgia, etc). I may never get definitive answers, but I'm tired of searching. For some of us, this may be a lifelong situation, and if you've gone years without obvious, debilitating progression, you could very well have multiple causes. Wish I'd known about the SFN / glucose situation sooner though. Be blessed
