Dear Will.,

I think you last sentence best reflects the situation. Yours is a well-reasoned and intelligent letter, and your symptoms sound like sensory PN to me. (And I have far more years of experience with anxiety than I do with PN!)

My first neurologist was so intent on disproving my hypothesis of sensory and autonomic neuropathy, he dismissed my positive skin biopsies as "artifacts." He also thought I was merely "anxious." (A diagnosis I was hoping for. Least serious.). I went to another neurologist. It turns out I have sensory neuropathy and severe autonomic neuropathy (dysautonomia). You don't appear to have dysautonomic symptoms, which is great...

You have to trust yourself.....you know you have pretty well-defined symptoms and you've done research. Yet, if you probe further, you may learn you may have small fiber neuropathy (NFS), which is not usually picked up by an EMG or nerve conduction studies. The definitive test is a skin-punch biopsy. I urge you to get it done soon, for peace of mind and because you may have a treatable underlying condition.

I understand your constraints about doctors, but I'm suggesting you move on. Because it is hard for me to travel (labile blood pressure), I do a lot of doctor research on the phone. Ask to speak with someone who has medical knowledge before you make an appointment. You might badger your existing Neuro to do the biopsies if this is more convenient....but I think you could use a sharper neurologist who knows appropriate testing, and who is more empathetic and less dismissive.

My sensory SFN is a drag and worsening, but it is not terrible. I control the pain with a low dose of nortriptyline (old school tricyclic antidepressant) and marijuana at night.

This forum is very helpful and I encourage you to keep researching.....we have to be our own doctors and advocates these days.

Best of luck...

Sylvie