Hi. I hope someone can comment/inform regarding this topic.
Here is my situation: Over 1 year ago my local neurologist referred me to a large University center to se a professor specialicing in neuropathy.
( my local neuro is actualy my neurovascular neuro)

This specialist saw me, did thorough physical neurological exam, and did EMG and NCS which he all performed himself.
Result Peripheral sensorymotor axonal polyneuropathy. Also evidence of small sensory nerve fiber dysfunction predominently affecting sympathetic components.
"To evaluate the small the small sensory fibers (autonomic nerves) sympathetic skin responses were obtained from feet."

I have asked this doctor to do a skin biopsy, but he has declined, saying," I do not need to do that, I have tested, I know you have small fiber neuropathy But if the local doctor will, they can easily do it there.

So, my local neuro, who referred me to the specialist, has been saying," If you have neuropathy, you should not have this brisk reflexes"
( I will need to bring in some information to the doctor. He obviously does not know that with SFN, one can have much of negative, normal assessment., EMG NCS included)

So the story goes, that recently our local neuro group has hired a new neuromuscular doctor that has done this skin test in the past, even though the office has never.
Well, he ordered the test, and I had it. Carefully documented and sent to Neuropath lab.

Result negative for SFN.

I have had such terrible painful symptoms with burning and all sorts of perasthesia.actually so bad that I almost mistook the symptoms for TIA a couple of times with really numbness in arm

Question:
How often are theese tests wrong?

Can they be repeated? ( Insurance company willing)

I have been so sick with this neuropathy in addition to newly diagnosed Rheumatoid Arthritis, that my rheumatologist has recomended to treat me with Rituxan.

No, We will have to make sure we get some objective documentation regarding the SFN.

Any suggestions?