The first news update tells us what we've surmised and picked up on our own...about how docs perceive their profession and what they actually do....
http://www.medicalnewstoday.com/articles/90876.php
Lots of room for thought inbetween the lines, yep.

This second is truly EXCITING!
http://www.medicalnewstoday.com/articles/90932.php
A way to actually see/count nerves that is non-invasive? I bet this one will be fast-tracked! No surgery, no scars and far less muss-fuss and accuracy questions than existing methods. I bet we'll see it in about five years, I sure hope so!

- j

Great articles.

I wonder how many fibro patients if given this new test will show neuropathy.

thnking the very same thing... Sue

im a little confused, it seems like a test that would detect small fiber neuropathy as does a skin biopsy. YOu can have long fiber neuropathy and have no loss of sensation. it does mention long fiber neuropathy in the article though.

There really isn't an entity of long fiber neuropathy. Small fibers are unmyelinated, those are referred to as C-fibers....C fiber neuropathy is hard to diagnose, as EMGs, evoked potentials, MRIs will not show small fiber neuropathy. Many, many people diagnosed with other conditions likely have small fiber or C fiber neuropathy. C fiber or small fiber neuropathy causes sensory symptoms of all kinds AND can cause autonomic symptoms of ALL kinds such as anhidrosis and POTS. C fibers or small fibers permeate the entire body.

The fibers to which you refer as long fibers, can be motor or sensory nerves that are myelinated. Usually those myelinated nerves will show some abnormalities on EMGs, MRI etc, altho not always. Abnormalities of the larger myelinated nerves are more detectable.

Then there are some 'thinly myelinated' fibers, those are included with small fibers....they generally deteriorate along with the unmyelinated ones giving rise to the name 'small fiber neuropathy'.

No one type of neuropathy is any better or worse than the other in terms of discomfort or functionality...they are both problems.

Glenntaj gave a good explanation in his post on CIDP. Both axons (the nerve cell) and myelin the nerve cell covering can deteriorate independently...and in small fiber neuropathy, there is no myelin to deteriorate...it is axonopathy or neuronopathy.

A non-invasive, cheap test will be revolutionary for diagnosing pain syndromes and will help to identify people who may be having autonomic dysfunction a lot sooner. It would be wonderful it this test is as good as it claims to be and becomes available to all.

Also having small fiber neuropathy does not preclude a person from developing a demyelinating neuropathy, and visa versa....some people have both.

This website might explain it better than I can.

http://www.neuro.wustl.edu/neuromusc...ory-large.html

neuro.wustl is chock full of good information. I highly recommend it.

While I certainly don't have the knowledge that Glenntaj or Cyclops or Dahlek has, it seems to me that it will eventually open more and more research and development into the type of tests that they are speaking of. And so many of us are teetering on the edge of damage and can't prove it. Take my own case. It took a sweatbox and a kind and caring doctor to get the diagnosis I have. Now what I'd like to be able to do is monitor my progress without the more invasive tests.

As far as the doctor situation in the first reference. It's still about the dollar.

Thanks for finding these studies and testing news. It is welcome very much.

Billye

--but it would really need to be expanded even further to be applicable to all types of neuropathies.

Dr. Dyck's assertion is quite accurate--this may become the gold standard for tracking disorders of larger fiber types, because the types of fibers that possess complex cellular structures such as Meissner's corpuscles are still mechanoreceptors (such as are described in the article)--not the generally unmyelinated A-delta and C fibers that subsume the sensations of pain and temperature (these are even smaller than the small nerves being described here). What this advance may really do is confirm neuropathy, non-invasively, in those who have normal or near-normal EMG/NCS results of the really large myelinated nerves.

Still, anything that can track nerve condition without cutting is a good thing.