Originally Posted by glenntaj

--since it affects the small, thinly myelinated and unmyelinated nerves that subsume the sensory functions of pain and temperature sense, as well as many autonomic functions such as sweating and blood pressure, is not disabling in the sense of motor breakdown or muscle weakness, as the small nerve fibers by definition to do not ennervate muscle.

But, having intractable pain from small fiber neuropathy, and/or disruptions of autonomic function, such as orthostatic hypotension--blood pressure dropping rapidly upon standing--can be quite disabling in that sense.

Most cases of small fiber neuropathy don't lead to wheelchairs or disabilities of that nature. The biggest problem generally is pain control and/or control of autonomic irregularities.

Of course, one can have a mixed neuropathy involving both small and large fibers--the latter, which are myelinated, subsume the sensory sensations of vibration, mechanical touch, and position sense, as well as motor functions, which is what is sounds like Elaine has, if she's had to use braces.

There is a tendency among neurologists to look at neuropathies that disrupt motor functions as more "severe" than those that are only sensory. This may be due to the fact that in the larger nerves, sensory fibers tend to exist more on the periphery of the nerve cable and motor fibers more in the center, so motor symptoms represent a more global process in the nerve. But for many people the sensory symptoms are worse as far as quality of life issues.