--if the cause of their degeneration is removed or at least mitigated. The rate is very slow, though--most sources list a rate of axonal re-growth at approximately 1mm/day under optimal conditions (meaning it might take years for some axons that start near the lower spine and extend to the toes). The growth cone fibers have to fight around and through other tissue to "hit" their targets, and there's no guarantee they will hit the original targets or wind up in the same place as before; genreally the patten of regeneration will not resemble the original enervation pattern. And, as this process occurs, one can have all sorts of bizarre sensations that may lead one to think one's neuropathy is getting worse, not better--the difference is usually apparent only in long-term retrospect.

I am an example of axonal regeneration; my acute onset full-body burning neuropathy--still officially "idiopathic", but with high suspicion of an autoimmune molecular-mimicry process--began on April 12, 2003. A skin biopsy on Jul 24, 2003 confirmed major destruction to the smaller nerve fibers, though my larger, myelinated ones, as measured by nerve conduction studies/EMG's, seemed intact. At the time, I had been reduced to 2% of normal intraepidermal fiber density. My neuropathic process seems to have been monophasic, though--a subsequent skin biopsy in November 2005 showed I had recovered to 11% of normal nerve fiber density (and my nerves were in much better shape, with much less swelling and excessive branching, both characteristic of small-fiber neuropathies). As a subject being followed by the Cornell-Weill Center for Peripheral Neuropathy, I will probably get another skin biopsy in about a year to see where the numbers then lie.

I have, overall, experienced fewer symptoms as time has gone by, though I am still prone to sudden "flares" of neural pain, and I am far more prone to compressive nerve effects than most "normal" people. I am currently dealing with a C5/C6 right radiculopathy that may be related to my tendency to compressive forces.

I am fortunate that I have evidence of nerve regeneration, and that a reduction in burning pain symptoms has come with it. Nevertheless, I am not asymptomatic, and cannot expect full nerve regeneration to average levels, according to most of the literature, which tends to rather hazily proclaim "slow, partial recovery". Part of the reason I am being followed is that researchers at Cornell-Weill are interested to see just how much regeneration I get over time. I have indicated that my supplement regimen probably deserves some credit for optimizing the conditions for such regeneration.