I found this interesting. Click on:

http://www.hopkinsmedicine.org/neuro...europathy.html

Also, mrsD and nide44 are exactly right concerning a sural nerve biopsy. You do not want one of those done. Go for a skin biopsy and that is more common now.

Hi,

It is in fact a skin punch biopsy and not a nerve biopsy. The Dr that is going to do my biopsy here told me it was done in the leg. I said to him that my problem started in the hands/arms , but he reply me that they only can compare with a database if the biopsy his performed in the leg.

I call Bako (in the US) and they confirmed to me. They told me that they can performe anywhere but they only have normal values to campare with if the sample is taken from the leg (10 cm abobe the ankle).

Anyway did you see my thread "very interesting" ? What ever happen to the Snail venom? Does anyone knows? It had so much potentials on neuropathic pain.

Filipe

PS: Thank you for continuing replying me. I though you were hangry with me because of my obsession with MRIs

Filipe,

I answered you about the snail venom... take a look at the other thread.

Glenn if you get a chance could you explain the 5 and 95 percentiles for small fiber nerve density. Does this mean its abnormal only if you have less than 5% or more than 95% of the average small fiber nerve density?

I also would like to know that

Back when they first started working on this at Hopkins, the reserachers were looking for a way to set a standard, since the degree of intraepidermal nerve fiber density is very individual, both among those with symptoms and those without, and from one spot on the body to another.

It was finally decided to consider a rather narrow range "abnormal", in order to get a fair degree of certainty that neuropathic damage actually existed for those people.

This is initially detailed in:

http://archneur.ama-assn.org/cgi/con...act/55/12/1513

Of course, as I've mentioned, it's possible for one to have small-fiber damage even if one doesn't fall into these rather narrow ranges; it all depends on at what point one started. It is known that intraepidermal nerve fiber density does decrease a bit with age, even in those with no neuropathic symptoms. And, if one starts in the 70th percentile, say, and something happens to reduce that person to the 10th percentile, they would not register as having abnormal density, though they might be greatly symptomatic. This is why a morphological examination of the fibers is also necessary.

What kind of morphological examination? Do they do that examinaton everywhere, o they just simply count nerve fibers loss?