EMG and nerve conduction studies only measure larger, myelinated nerves. Abnormal results on these do point to some form of neuropathy--at least of those nerves. But these tests will generally only show gross levels of damage, and not right away--it often takes weeks following an injury or disease process to damage the nerves enough for abnormal results to become apparent.
[B]thanks! So if I've had this already for 2 years with "normal" emg/ncv, Does it mean it truly rules out long fiber neuropathy? Or can I still have it?

Could small fiber neuropathy be causing all this muscle weakness and twitching, along with pain increasing in feet over this time?
Emg/NCV said no motor neuron disease signs, the dr says...B]

And, more importantly, EMG and nerve conduction studies cannot detect certain types of neuropathy--those that preferentially affect the small, non-myelinated nerves that subsume the sensations of pain and temperature and also control many autonomic functions. These can be detected through specialized types of testing--sudomotor axon reflex testing, qualitative sensory testing, and (the current gold standard) skin biopsy to enumerate intraepidermal nerve fiber density and condition.

Ok, will work on this one. Whatever I have, began as leg weakness(also shoulder/arms/hands grip to a lesser extent), muscle twitching, cramps/spasms(like charlie horse, in calves), then slowly developing increasing pain in feet. The sensory stuff has been slower to show, aside from pain(I guess that's sensory); slowly beginning to feel a cold burn in feet(usually aware of it when at rest, usually in bed), momentary sharp stinging pains in hands and feet, vibrations when standing on feet.....
Can small fiber neuropathy present like this?
What is sudomotor axon testing?

In point of fact, the most common presentation of diabetic neuropathy is small-fiber, as is the most common presentation of idiopathic neuropathies. So normal EMG/nerve conduction results in the presence of symptoms should prompt further investigation.

I will be pushing, it's just so frusterating and expensive, when does it end
Thank you for your thoughtful information...