[Megan]

As SFN has not been established or proven by QST in my case, is there any other diagnosis at all that can cause the stocking (very predominant) and glove sensations?

I also have 24/7, continual burning of the lower legs and other areas of the body in rotating shifts, fasciculations (50-100 per day) and marked electric current/buzzing sensations in feet and legs.

As I have significant amounts of muscle fatigue, joint and muscle pain and very tender points all over my body I have lined up to see, in a couple of months time, a doctor who specialises in Fibromyalgia/CFS. However the neurological symptoms don't seem to fit at all with that diagnosis.

Anyone have any clues?

[glenntaj]

--the most typical presentation of most types of neuropathy--small-fiber, large-fiber, or mixed types (sensory and/or motor) is stocking-glove (though it's not the only presentation).

That's because in many of the underlying conditions that cause neuropathy, the nerves "die back"--they are damaged first inthe areas farthest away from the body core, as it is longer/harder to transport oxygen/nutrients to there and waste products from there.

It's also quite possible to have such symptoms from spinal or other central nervous system dysfunctions (i.e., seizure disorders).

Normally, a normal NCV/EMG study series--if done thoroughly, over many body parts--will rule out extensive large fiber dysfunction. But normal QST does not generally rule out small-fiber dysfunction; it depends on which fibers are being preferentially damaged. I had normal QST, but extensive small-fiber damage revealed by skin biopsy (still the gold standard for diagnosis of that kind of damage).

Could you refresh us as to what type of testing you've had to this point?

[mrsD]

Here is a very good article on stocking/glove and nutritional neuropathies:

http://www.emedicine.com/NEURO/topic278.htm

[BEGLET]

Hi Megan -

My PN started literally overnight - I woke up completely numb up to one wrist and on the same side of my body - up to my ankle - it never went away - just progressed.... I didnt realize how much until I saw a neurologist and they did nerve testing..... I was first sent to by an HMO to a orthopedist who told me he'd never heard of such a thing - and was poo poo'd out of the office... when I finally got to see a neuro after repeatedly requesting such a visit from the HMO - she immediately determined I had neruopathy..... it took extensive testing to finally determine its both large and small fiber, demylinating and degernerative - and by then much damage had been done.... my diagnosis is CIDP.... (my most telling tests were the NCS/EMG and sural nerve biopsy (which I understand now there are better alternatives to on the biopsy).......

Would defintely recommend you check out mrsd's recommended site - as well at the stickies here!

[Megan]

Thankyou mrsd for that link I will open it when I finish writing this.

At very big risk of repeating myself Glen the tests I've had done have all been negative:

EMG/NCV; Brain MRI; chest, abdo and pelvic CT; QST; numerous blood tests for Vit B12; Folate; Homocysteine; CA125; ANA's; ANCA's; FBE/CBC; LFT's; U7E's; TSH, T4,T3; ACE; SPEP; Endomysial A & T-glutaminas; GTT; ENA's (extractable nuclear antigens); and urinary porphyrins.

The GTT had a big dip on the one hour reading and the two hour reading came back to the baseline fasting reading - considered a normal result even though it is called a 'flat line' reading.

When I had the ANCA's done originally the comment came back that they couldn't determine the presence of ANCA because of the presence of ANNA (Anti Neutrophil Nuclear Antibodies). When I mentioned this to the second neuro I went to (because you mentioned that this could be important) he then ordered the ENA's - which were normal. You have already responded to that in a message a week or two ago.

So I am going in circles really - although trying not to spend too much time thinking about it - just living! The terrible fatigue and brain fog that I had for four months has lifted significantly since I started on the shark liver oil and the N-Acetyl-L-Cysteine.

Within two days of starting the shark liver oil I physically felt one afternoon at 3pm my thinking becoming clearer as though a veil had been lifted. It was truely extraordinary. I've never had such an amazing result from ANY supplement that I have ever taken...amd I was quite negative about taking it too and spending more money on yet another useless thing! By the third day the incredible fatigue had gone and this lasted for five wonderful days.....then the fatigue returned - but not as bad though. This was when I added the N-Acetyl-L Cysteine and a couple of other things and have been coming out out of the slide again to the point where now I am just feeling 'normal' tiredness.

So that's about it in a nutshell. The fatigue much better but the PN the same.

[glenntaj]

--because is does give an idea what to go on.

I noticed two areas that you did not mention, that would be very important to have tested:

First, they should be giving you an immunofixation electrophoresis of serum and urine for rogue monoclonal antibodies (M-proteins). When these are found, the condition is termed monoclonal gammopathy. In about one-third of cases, this is associated with some form of blood dyscrasis, but in two thirds it isn't and is termed monoclonal gammopathy of undetermined significance (MGUS). This is a fairly common cause of neuropathy, as the rogue proteins cross-react with certain components of peripheral nerve.

In keeping in that vein, you should probably be titred up for some of the SPECIFIC antibodies for peripheral nerve--the GM, GD, GQ series, anti-sulfatide antibodies, anti-MAG (myelin associated glycoprotein antibodies), and a few others:

http://www.neuro.wustl.edu/NEUROMUSC...y/mprotein.htm

http://www.neuro.wustl.edu/NEUROMUSC...oantibody.html

(Forgive me if you've had any of these before and this repetitive.)