Over the years, I have suffered with what was originally diognosed as a length-dependent small-fiber neuropathy based on serial skin biopsies (but with relatively normal blood sugars).

My symptoms (burning along Eustachian Tubes, above and below eyes, ect.) originally began in my face in 2005 which responded well to Carbamezapine (suggesting 5th Trigeminal Nerve involvement). This was also the first area where I was ever affected by neuropathy.

Fortunately, I discovered Cymbalta that summer which I switched to and which worked beautifully.

Over the years my face pain essentially resolved (by 2008), whereas in 2006 and 2007 my small-fiber neuropathy first began in my calves, hands, and forearms. I then used Cymbalta on and off over the years with moderate success. I also began using supplements (circa 2008) which I have since refined over the years (Methyl B-12, Vitamin B-3, ALA, ect.).

My widespread small fiber symptoms, in-turn, have been getting better since the summer of 2009, and when I do experence them it is typically limited bilaterally to the palms of both hands. I now live essentially off medications except for very rare use of Lyrica or Cymbalta in a flair.

I should also mention that I periodically have noticed a sharp stinging or burning pain in the very tip of my tongue that might wake me up from a nap. However, I have not paid much attention to it as it is extremely infrequent.

Unfortunately, I have just noticed within the last few days an odd sensation when I drink hot or cold drinks. A first it felt like there was something in the fluid that was tingling my tongue.

To my horror this morning, I now realize that I am beginning to get a rather steady tingling or even numbness across the top of my tongue which is very disconcerting. Especially since I do not know either the cause or how severe this may become.

Could anyone who is knowledgable about I am experencing please give me some insights into what may be happening. If this progresses, would Cymbalta or Lyrica be helpful (as I would suspect that this might be small-fiber issue but now in my mouth ... ugh!).

I should also mention that I have been suffering from an upper-respiratory infection for several weeks now that I have just started taking Augmentin 875 mg x 2 daily for 10 days to treat (began as a sinus infection).

I also have not noticed any physical changes to the appearences to my tongue.

Thanks!

David