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Old 12-29-2007, 08:36 PM #9
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Alkymst Alkymst is offline
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Alkymst Alkymst is offline
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Join Date: Jan 2007
Location: Pennsylvania
Posts: 231
15 yr Member
Default What she said!!

Elsie,
I can only echo Melody's sentiments - BY ALL MEANS FIND A NEW NEUROLOGIST - you definitely need someone who understands PN and thinks beyond a cream for a treatment program. She may have concluded that you have idiopathic PN simply because she doesn't know what to do now or next. You'll have a wealth of suggestions from people very soon.

One test that can be very useful is an oral glucose tolerance test OGTT, 2hrs at a minimum and preferably longer. ~30-40% of supposedly idiopathic PN cases have now been diagnosed as a prediabetic form of PN that can occur long before a frank presentation of diabetes - the IGT or impaired glucose tolerance is a predominately sensorimotor SFPN (small fiber peripheral neuropathy) and many times is painful. The OGTT is the best way to identify these cases - they are not caught by a fasting BS or hemoglobin A1c - there are many documented cases of patients w/ normal fasting BS (<100) and hemoglobin A1c values <6 who have abnormal OGTT @ 2h, i.e. >140 but <200 who suffer w/ PN. Some of the other confirmatory diagnostic tests for SFPN include QSART (quantitative autonomic sudomotor reflex test), QST (quantitative sensory testing) and skin punch biopsy.

Also, SFPN is not diagnosed via needle EMG (electromyography) or NCV (nerve conduction velocity) studies - these tests are much more useful to document abnormalities in the larger nerve fibers.

Hope this is useful and if I can help you, by all means pm me - I know you'll get a great deal of information from other forum members too.

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