And you're right--small-fiber neuropathy cannot be found/eliminated by nerve conduction or needle EMG studies, which can only meaure the gross activity of the larger myelinated nerves. But, Quantitative Sensory Testing IS designed to provide measures of small-fiber nerve responsivity, by noting if you one can percieve temperature differences, and warm/cold induced pain--the small, unmyelinated fibers are the ones that sense pain and temperature.

It's certainly possible for one to have damage to both the smaller and larger fibers simultaneously, and that would point to a more global, systemic origin of the neuropathy--has there been any serological/urinary testing? And, if there's a neurosurgery consult coming up, does that imply that someone thinks this is related to spinal problems? Have MRI's been done? Problems with the spine/nerve roots can have symptoms that exactly mimic those of more distal nerve problems, and narrowing down the spots is not always easy . . .

As I often do, I'm going to refer you to the Liza Jane spreadsheets, which list all the tests for nerve related problems that many of us could think of--and they're great for tracking test results over time, or suggesting further ones to doctors:

www.lizajane.org