Hi,
Nash here. Desperately looking for help related to suspected small fiber neuropathy. Below is the history.
1. Started off with gut infection and then recurring UTI in Aug 2013 (was on cipro, nitrofurantoin) post bad emotional trauma.
2. In October 2013, pelvic pain and bladder dysfunction with pain in right feet
3. After 20 day course of Cipro and Tinidazole for suspected prostatitis, in December 2013 I started having gastro issues with severe constipation with oversensitive, pins and needles left big toe started.
4. In Dec 2013 was on chlordiazepoxide and clidinium bromide for sleep and depression issue post gut issues.
5. For pain in leg and pelvic area, I was put on Gabapentin 300 mg once daily for a month in January 2014. EMG and MRI done in March 2013 came out normal except for suspected absence of Sympathetic Skin Response (small fiber) and L4-l5 moderate disc bulge. 24 Antibody autoimmmune came normal.
6. In Feb 2014, I was put on amitriptyline Hcl 10mg by Neurologist for nerve root irritation. In March 2014, I was put on Steroids 8 mg (twice daily) for a month and paroxetine HCL 12.5 mg (1/2 daily) stopped after few days as paresthesia worsened and was put on klonopin and escitalopram (1/2 daily) for pain and paresthesias with Levosulpiride twice daily for gut issue.
7. Clonazepam and escitalopram and Levosulpiride was stopped suddenly due to horrible gastro issue in May 2014 end. I was throwing out everything that I ate.
8. Then in June 2014, I was put on multiple antipsychotic drugs (like Clonazepam, escitalopram, Tianeptine 37.5 mg, Pregab 75mg etc.) for two months. Also was on antibiotics (ofloxacin, cefixime) for rectal infection due to fissure.
9. In August 2014 due to sharp burning like trigeminal neuralgia developed in face and Dr's advised to stop all medicines and was put on Amitriptyline Hcl 10mg again. Was also on bovine colostrum for fatigueness and history of recurring sore throats. Was on multiple supplements like Vit b12, carnitine, Alpha-lipoic acid and biotin etc for almost two months.
10. For horrible paresthesias (buzzing, vibration) that developed in palms and feet, I was put on Clonazepam 1/2 daily for 10 days. In September 2014, hypersensitivity developed in shin area with burning in shins whenever water touches that area. I was put on Duloxetine 20 mg twice a day. Vit b12 (methylcobalamine) 1.5 mg daily.
11. In October 2014, buzzing in upper back near left shoulder blade and then pain developed in that area on bending forward. Then odd rough dry sensation with mild burning with burning in finger tips developed in palms. Then burning progressed in soles and shin with worsening of odd paresthesias. Was on Steroids 8 mg twice daily again for 1 month for paresthesias.
12. Current symptoms:
• Odd rough dry, mild burning sensation in palms with burning in finger tips while typing
• Horrible burning in shin,feet, sole areas with tingling and buzzing in sole areas. Severe hot water like paresthesias near shin area more in right leg. Alternate hot and cold feeling in shin, feet, palm area. Pins and needles in finger tip and toes. Reduced after taking duloxetine 20 mg.
• Buzzing in upper back near left shoulder blade and horrible pain in same area on bending forward
• Hypersensitivity in shin (mild burning on when trousers touches that area). Hypersensitivity in face, forearms and legs in thigh (with burning pain in thighs on sitting), skin in entire body easily bruises, turns red on even mild mechanical stress.
• Horrible paresthesias (buzzing, tight water like in shin) in legs worst on sitting or bending knees. More on right leg. Pain in knees and elbows on little use.
• Fatigued with mild physical work. Recurring sore throats.
• Severe constipation since Dec 2013. Bladder dysfunction and pain in pelvic area while sitting.
• Hypersensitivity to food and other drugs.
Currently on homeopathy medicine for burning, Duloxetine 20 mg once daily and Pregab 75mg + nortriptyline hydrochloride 10 mg once daily.
Based on above symptoms and some research that I have please let me know whether it is;
1. small fiber sensory/autonomic neuropathy (could be post infection pudendal neuropathy), or
2. severe benzo/SSRI sudden withdrawal symptoms or
3. Fibromyaglia type II (neuropathy type driven by overactive sympathetic nervous system with involvement of limbic system) or
4. Cipro neurotoxicity or
5. ???

Neurologists are clueless about the condition and skin biopsy for SFN is scheduled after 2 months. No test available for Autonomic nerve fiber dysfunction. Other immune test and pathological test scheduled after few weeks. Recent EMG came out completely normal with presence of sympathetic skin response.
Kindly let me know if more info is required.
(Disclaimer: medicines mentioned in this post are not intended to substitute any medical advice. Kindly consult your doctor and take medicines only under registered medical practitioner’s supervision only)