--doesn't necessarily rule out small-fiber neuropathy processes; it may just be that the processes have not yet advanced far enough to be really noticable.

People expereinced in reading the pathology results are necessary, as both the intraepdiermal nerve fiber density AND the conditon of those nerves (e.g., swelling/branching) need to be looked at. Density can be within "normal" ranges--the McArthur protocols usually put this as between the 5th and 95th percentiles of normed density (a little wide, I think--for an individual, whether you are reduced out of this range may depend on where you start), but if the nerves show abnromal sprouting/branching, that may be a sign of neuropathy.

Then, too, if your syndrome is predominantly larger fiber, your small fibers on skin biopsy may "look normal".

What other testing have you had (I think you also mentioned a nerve biopsy--was that of the sural nerve)?