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The difference between NLD and LD SFM
I guess mine is non length dependent since my upper thigh showed more significant damage then my foot at the time of the test. I bet if they tested it now, the foot has caught up.
Anyway, are there different causes for the two types? Mine started in my left leg and hand. It was nothing but an annoyance for about a year then it went to my neck, face, shoulders, and right limbs as well. It is in my whole body now except for my abdomen. Are there different protocols and research for the etiology of NLD vs LD? |
While there is some overlap--
--it is currently thought that non-length dependent forms of small-fiber neuropathy, especially, may more likely result from neuronopathy, which involves damage to the cell bodies in the dorsal root ganglia, thereby damaging the whole nerve cell. Length dependent neuropathy, which is more common, refers to the end fibers farthest from the center of the body being affected first, often with gradual "die-back" towards the center over time.
Length dependent neuropathy often involves an ischemic or circulatory component; it's harder to get nutrients and oxygen to, and waste products away from, nerve fibers that are farther from the seat of circulation if there is circulatory compromise, so those far away areas tend to be affected first. Diabetic neuropathy, for example, usually presents in a length dependent manner, as the deleterious actions of high blood sugar involve compromise of blood vessels (among other things). Non-length dependent neuropathies show a greater percentage of toxic or autoimmune causes, as these are systemic and don't often just congregate at the extremities. But, if the autoimmune attack is on blood vessel walls, as in many antinuclear antibody related conditions, some of these may present first at the extremities, too. It's really a complicated issue that it may take a lot of research to clarify. |
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I found another neuromuscular dr. who at least ran a few more tests, but just said at this point its idiopathic, so we have to watch and then maybe get another rheumatologist or vascular dr opinion. No skin off his back for me to just wait. This is torture. Also, why did neither of them tell me its NLD or LD? All they say is idiopathic SFN/ autonomic symptoms. I'm assuming that mine is NLD since it started one sided and didn't flare till it got my neck. Then it went to the other foot and side of my body? |
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