--objective symptoms of nerve damage can vary widely in type and intensity even among those with very similar clinical findings.

If there was no finding of any structural abnormalities or evidence of central nervous system demyelinating disease on MRI then the next logical step, given the somewhat ambiguous VEP/QSART results, would be a comprehensive small-fiber/autonomic work-up, which might not only include a lot of the laboratory tests from the Liza Jane spreadsheets (www.lizajane.org) but perhaps a repeat of the skin biopsy to check for any changes int he last two years. Fortunately, skin biopsy is easily repeatable, and the change in the numbers, if any, may give you some inkling as to how the situation is progressing.