--has never been definitively etiologized, but a post-infectious autoimmune molecular mimicry process is strongly suspected. The theory is my body absorbeda pathogen, probably fought it off, but the pathogen had a molecular structure that was similar enought oc ompnents of my small-fiber nerves that the now-activated immune system could not shut off until it basically destroyed my small-fiber nerves. (This seemed to be the evidence from my first skin biopsy, which showed I'd bascially been reduced to 2% of normal intaepidermal nerve fiber density.)

I do seem to be getting some recovery, along with reduction in symptoms--my last skin biopsy showed I was up to 11% of normal intraepidermal density. (I'm due for another one in November.)

This type of presentation seems to be rare--an autoimmune attack on larger, myelinated nerves, such as in Guillain Barre syndrome, is more common--but in both cases the prognosis is long, slow, partial recovery. I do seem to have some permanent damage, in that I now am much more prone to compressive nerve effects than "normals".