Yes, Neurologists who are knowledgeable and helpful will diagnose. SFN can be diagnosed on exam alone. From my experience and what I have read, most doctors will not do this, as now they want objective evidence.

The NM doctor is doing you a disservice by not saying the biopsy is not medically necessary. If your symptoms persist, then a skin biopsy is appropriate. Your treatment might be the same, but the way you are treated (talked to, listened to) would change.

You may already know about these, but these are good links to share:

http://www.hopkinsmedicine.org/neuro...europathy.html

https://www.therapath.com/tests/skin...ber-neuropathy

Big teaching places like the sweat test, QSART, etc. This brings in big money. A skin biopsy take a few minutes, but with labeling, sending out etc., there is not much charge (if insurance will cover).

Good luck!