Hi there,

I just wanted some advice from you peeps.

I have been diagnosed with SFN through skin punch biopsy by a prof in London.

He wrote to me advising that my skin biopsy showed my nerves were re-generating too much and noted it is in contrast to diseases like diabetes were there is a loss of nerve fibers.

When i have read online i can't find much about this, from my understanding it says there is a loss of nerve fibers with most SFN

I have SFN all over, i took Metronidazole twice in November and December 2012, and i noticed symptoms starting on New Years Day 2013. The prof noted that my skin biopsy is in keeping with a drug induced neuropathy/chemo induced (i haven't had chemo). He also noted it was in keeping with neuroinflammation or an autoimmune disease. I have had a full work up including lumber punch which has all come back normal so far. I am having a lip biopsy for sjogens in a few months.

I am 37 this started a few years ago with odd sensations all over my body. i didn't get any burning until i was told it could be SFN, the neuro said the anxiety had brought it all out

So the prof suggested it could be the metronidazole, he said the first case was reported in 1976, but he said i needed to be fully checked first which i am.

So does anybody think this could have been the drug? I am hoping this was the cause as the neuro suggested it won't get worse, but she also said it won't get better even if it is that.

Hi LouLou,
I'm awake and online and saw your message.

I just wanted to suggest that you could search this PN forum and the subforum PN Tips, Resources, Supplements & Treatments

http://neurotalk.psychcentral.com/search.php

You will find posts about neuropathy and Flagyl / Metronidazole. Try both names Metronidazole and Flagyl.

thank you for that, I will have alook. I haven't read much about metronidazole causing non-length dependent neuropathy though. Also I don't know if anybody has heard of a skin biopsy showing too much re-generating of nerves?

I am not familiar with a large cross-section of biopsy results but this is the first time I have heard about accelerated regeneration. Quite the contrary. hope your symptoms will improve at a comparative fast rate also. Good Luck, Ken in Texas.

Glenntaj is the one to consult. I seem to recall his saying that
the skin punch biopsies will show regeneration (the cells are immature etc)...

But really "too much"...that seems a bit unbelieveable. I think patients are lucky to get "any" regeneration"... but too much? This too much seems unrealistic to me.

When my hypothyroid issue was corrected, I remember my numb feet (they first were very painful, then became mostly numb)...
"woke up" and tingled and burned for just about a year as they
improved from my thyroid hormone. So yes, sensation may return and feel pretty bad as things fix themselves, but "too much"? I have never seen that posted here by anyone.

Hi there,

Thank you for the replies,

maybe I haven't explained this properly so ill read the letter from proff

"We proceeded to skin biopsy of the calf which showed a clear increase of intra-epidermal fibers with the gold standard structural marker pgp9.5 at 11 fibers/mm the normal range being 6.5. Other intra-epidermal markers were similary increased, including GAP43 which is a marker for regenerating fibers 3.1 fibres. the normal range being 1fibre/mm. This is in contrast to conditions such as diabetic neuropathy where there is a loss of intra-epidermal nerve fibers.

The skin biopsy findings are in keeping with neuroinflammation or autoimmune conditions and can be seen in patients who have had drug treatments or chemotherapy" He goes on to suggest this is seen in sjogens syndrome and said voltage gated potassium channels can also cause this.

does this make more sense as it makes none to me! trust me to be different.!!?

Is this your second biopsy results? Did you have a test before this one? Or is he comparing your results to a "norm" that they use? Glenn has stated many times here that the biopsy itself is
only an estimate and that people vary...some have more fibers to start with than others, etc.

Send glenntaj a PM and ask him. He is very knowledgeable.

Hi Mrs D,

No this is the first biopsy I've had. He is just comparing my biopsy to normal people of my age.

I don't really understand. When I asked the neuro she said it can go either way but I've never heard of them re-generating too much.

It just gets more frustrating and worrying.

Is Glenn a neurologist?

I don't know if glenn is a neurologist but from reading the site he seems to know his stuff.

I hope the results mean that maybe something irritated my nerves and my nerves are trying to sort themselves out.

Well, that's what i'm trying to tell myself and I am hoping and praying that they will one day.

thank you again everyone, you have all been very kind and helpful.

Loulouxx