MY Neurologist says I have Peripheral Neuropathy but does not no what is causing it, after going through a Nerve conduction test, MRI Test, and Cat Scan, all with no results is it really necessary for him to do a lumbar puncture? The symptoms are fairly bad all over my body.

How about asking for a skin punch biopsy first ? If your other tests are normal it might be the small fibers that are causing the problem.

The test is very easy......a couple of 3mm skin punches (they deaden the area first) and then they cover it up with a bandaid.

Maybe ask for that before going to the lumbar puncture ?

I had the same tests as you and they were all normal until the skin biopsy. And it showed I had small fiber neuropathy.

Just a suggestion. Please keep us posted.

Debi from Georgia

Hi Terrence

Welcome to NT. Hopefully someone will be along soon to give you an accurate answer to your question.

Maybe your neurologist has a specific reason for wanting a lumbar puncture (ask him why he wants it done and what he expects it to show before you consent to the procedure). It's not unusual for people here with PN to have had a skin biopsy (a punch biopsy) done to look for small fiber neuropathy. Sometimes this gives a positive result and confirms the diagnosis - but also a negative result can be found but the person still has some form of neropathy.

There are more than 100 different types of neuropathy with just as many causes. Trying to identify the cause can require a lot of 'detective' work. I'm guessing you've been tested for Diabetes (this is the most common cause). Has your neurologist also checked your Vitamin B12 levels. If you can get copies of any blood tests your number should be above 400 pg/ml. The range still used by many doctors of a lower level of 200pg/ml being normal, is out of date.

There is lots of information on here about various types of PN. Take time to browse the PN forum - being informed will help you manage the condition.
I'll put in a couple of links here to websites which I've found useful:

http://www.ninds.nih.gov/disorders/p...neuropathy.htm

http://www.clevelandclinicmeded.com/...hy/Default.htm

It sounds as though you have a neurologist who is being thorough and not dismissive of your condition - many here don't get such a good response. If they're empathetic and willing to work with you to manage your PN then you're in good hands. Doctors are often pushed for time with explaining things so it may be usedful to take notes and come here for help with the details.

All the best for progress. Let us know how you get on.

Vitamin B12 is good and no diabetes.

Could damage from the cold cause Neuropathy?

Have you been on any medications? This is probably the one thing Doctors won't look into (for obvious reasons) and there are many that can cause PN issues.

I'm new to issues related to PN but was on two medications that we think led to b12 deficiency (daily dose of protonix for acid reflux for over 10 years and recently, was on daily dose at a level of 2000MG of Metformin for 18 months).

My b12 serum was over 800 but I had (and still have) significant neurological issues (PN in feet, ankles, lower legs and trembling, muscle twitches throughout body). Mine presents more like a polyneuropathy which also is indicative of b12 deficiency.

I recently read that low serum b12 is a lagging indicator of a deficiency and that being symptomatic of neuro damage is enough to warrant aggressive b12 therapy (1000 mg daily injections of methylcolobalamin for 2 to 3 weeks; then weekly injections).

First and foremost it's important to stop the progression of the damage, so we started the b12 therapy without doing any other testing. It could take a month to schedule and get further testing; if it's b12, we'll know in a couple of months. So far my symptoms have not worsened, but they also have not improved other than it seems I am walking better ... feeling a bit more sure-footed.

Once again - I am new to all of this so others who are better informed should feel free to correct or add to this information.

I met with 3 different docs, none of whom even ASKED if I was on an acid reflux med or metformin! In fact, one of them was the doc who PRESCRIBED daily doses of Protonix for over ten years and never suggested that I cycle the med to prevent issues with absorption of b12 (or calcium or other important nutrients).

remember... you have to stop your B12 for several days before any testing, to get an accurate result. False elevations are useless to see where you are now after your supplementation.

Im on tacta for acid reflux, as well as endocet 1/2 tablet 4 times day as needed, and Coversyl for high blood pressure 8mg once day.plus Gabapentin which is utterly useless. Thats it for medications.