[QUOTE=glenntaj;957591]--how was the small fiber neuropathy diagnosed? Was there specialized autonomic testing (such as tilt table), sudomotor axon reflex testing, qualitative sensory testing, or skin biopsy?]

My Neuro did the skin biopsy then sent it to Therapath in New York:
A. Right Thigh-Value 3.6, Abnormal <6.8
B. Right Calf-Value 1.1, Abnormal <5.4
Diagnosis:Skin with significantly reduced epidermal nerve fiber densistant with small fiber neruapathy in both samples.

I honestly believe my Neuro was not very familiar with SFN until the biopsy "surprised him". On my last visit I asked about his experience and he gave me a strange look and said he was not above getting a referal! He printed a check list from Mayo Clinic showing possible causes of "Peripheral Neuropathy" showing all the causes that he had checked for except one. Then he did blood work for Lead, Arsemic and Mercury which came back negative. I asked him again about if my previous back (Sciatic nerve) injuries could be a possible cause and he told me nerve injuries only amount to 4% of neuropathy.

I believe he is one of the too many Neuros that do not know that SFN is in a sub-classification of Neuropathy and should be treated as such! Non-Diabetic SFN falls into a more mysterious catagory.

Last week I sent very specific emails, including the tests performed and my back history, to many Neuros in my area and in the state of Georgia requesting help afor SFN and have not heard from any. I also sent one to Dr. Lan Zhou at Mount Sinai in New York, she said she would assist me if I can get to New York. I called Medicare and they said they would not cover travel and expenses outside Georgia and living on Social Security makes that impossible.

I feel, like a lot of non-diabetic SFN folks that there is no hope and I will have to rely on medications for a reasonably decent life.