Abnormal EMG With Small Fiber? VERY Confused
 

I've read everywhere that an EMG can NOT pick up Small Fiber Neuropathy, I had an EMG and it picked up NO response in my Plantar Nerves on both feet and my Doctor said that it indicated Small Fiber Neuropathy.

So is it OR isn't it possible? Is my doctor wrong??

I'm SO confused, I have burning all up my shins, why didn't that show up with no response?

I want to say your neuro is wrong.

Non-response is not a small fiber problem.
(that generally indicates a much larger problem on board)

The burning is indicative of a sensory problem.

If you have sensory+SF I'd be inclined to tell ya that you have diabetic neuropathy.
But, based on your EMG, I'd be less inclined.

One can certainly have--
 

--damage to both the larger fibers that are measureable by EMG/NCV tests and to the smaller fibers simultaneously. But standard EMG/NCV testing can only isolate fairly large, myelinated nerves and make determinations of fairly gross dysfunction (a "small" ambiguous deviation from norm may or may not get picked up).

Now I have heard of neuros who, after a nomral NCV/EMG series in a person complaining of symptoms, then conclude that the problem must be small-fiber. But they should probably continue attempts to document it, through qualitative sensory testing, autonomic testing, or skin biopsy.

So if it isn't Small Fiber, (which I do have symptoms of), what else could it be? I don't wanna call my neuro out, I'm just worried it'll keep progressing :(

No response on your plantar nerves--
 

--would seem to indicate you do have at least some larger fiber involvement.

It's certainly possible to have large and small fiber involvement at the same time, though. Many neuros, if they find abnormalities on NCV/EMG studies, will say you have a neuropathy and won't go much further in investigation.