Quote:
Originally Posted by glenntaj
--can also involve dysfunction of the small autonomic nerves that help to control blood pressure, circulation, even the rate at which food passes through the intestinal tract.
It is not unusual for those with small-fiber neuropathy to have some degree of autonomic dysfunction, though it usually doesn't rise to the level of full blown dysautonomia. Often, it is subtle (and, as the researchers say, "subclinical".)
See:
Autonomic Differential Diagnosis
Small Fiber Sensory
Pain Differential Diagnosis |
Thanks. I'm all too aware of this mild dysautonomia having been told by my neurologist that I probably have what she calls "mild ganglionopathy" - a form of autonomic dysfunction associated with my confirmed Sjögren's Syndrome (i.e. not idiopathic) alongside presumed SFN. I have GI problems at both ends and don't sweat appropriately, suffer sexual disfunction and cranial neuropathy - and have disequillbrium and tinnitus - all apparently caused by proprioceptin issues as part of the presumed SFN and Ganglionopathy of my diagnostically confirmed Sjögren's. An audiologist and opthamologist have both recently confirmed that my issues are most probably neurological as part of my rheumatic disease.
So the thing I'm really asking about is whether this sometimes includes a vasospastic process, if a person has colour and skin density changes in their digits and extremities - such as I have and ElaineD has described? And does this come under the heading of secondary Raynauds Phenomenon or not? Or is a different clinical process involved in causing these colour changes as part of SFN to the process involved in secondary Raynauds Phenomenon to advanced SFN? I'm aware that both can lead to ulcerations and loss of digits/ gangrene at their most severe - so what is the difference, if any, between these two conditions?
I'm still very confused about this and am being assessed for possible Scleroderma so it is important to me that I get to the bottom of this I feel. My sense is telling me, after these replies, that my problems are neuropathic and autonomic but this has not yet been histologically or physiologically confirmed. The first rheumatologist thought SFN but skin biopsy did not confirm. Then my GP and an eminent rheumatology professor told me three years ago that t was secondary Raynauds rather than peripheral neuropathy.
Now a second neurologist is saying it's SFN with gangliopathy, but says tests are not available where I live and anyway aren't necessary because my description and Sjögren's diagnosis are enough to go by. They aren't enough for me though - I like hard evidence rather than presumed diagnoses!
And I'm still none the wiser I admit but I worry most about atherosclerosis/ PAD as a third alternative possibility because of my family history.