Hi, it was not until seeing my fourth neurologist that a skin biospy was ordered, even though I had suggested it as a possible procedure to numbers two and three (I had done my own research and strongly suspected that I had small fiber neuropathy before seeing my second neurologist. Yet both of them, one of whom was at one of the Mayo Clinics, could not figure this out!) So on my fourth neurologist...he seemed a bit miffed that one had not been ordered previously. He ordered one the first day that I saw him. Bam, came back that I had small fiber neuropathy. I was so angry that for a while I considered suing the previous guys for not doing what I, the patient, had figured out ought to be done.

Point is, it's been my experience that neurologists are either ignorant of small fiber neuropathy to an extent or skin biopsies are just woefully underutilized, or both.

Next time you see one, if you are still having the sensory problems, you might want to demand one or demand to be referred to a neuro who does one. Maybe it won't come back as sfn, but that test would be the best way to figure out whether it is that or not.