Neuropathy testing can help diagnose small fiber neuropathy by
testing a small sample of your epidermal nerve’s fiber density, often referred to as ENFD.
Neuropathy is a peripheral nerve disease that selectively affects small diameter nerve
fibers. The test is highly specific and sufficiently sensitive with a 97% accuracy rate.
Common causes of small fiber neuropathy are diabetes (types 1 and 2), HIV, vibratory trauma,
amyloidosis/monoclonal gammopathy, alcohol abuse, pharmacologic toxins, solvent exposure,
and/or idiopathic neuropathy.
Your Foot & Ankle Specialists specialize in neuropathy testing and can quickly diagnose and
set you on a path with expert action and planning, working hand-in-hand and step-by-step
with their patients to achieve the best possible results.
Peripheral neuropathy has many possible causes. Besides a physical
exam, which may include blood tests, diagnosis usually requires:
- A full medical history. Your health care professional will look at your
medical history. The history will include your symptoms, lifestyle, exposure to toxins,
drinking habits and a family history of nervous system, or neurological, diseases.
- Neurological exam. Your care professional might check your tendon
reflexes, muscle strength and tone, ability to feel certain sensations, and balance and
coordination.
Tests
Your Foot & Ankle Specialists may order tests, including:
- Blood tests. These can detect low levels of vitamins, diabetes, signs
of inflammation or metabolic issues that can cause peripheral neuropathy.
- Imaging tests. CT or MRI scans can look for herniated disks, pinched
nerves, also called compressed nerves, growths or other problems affecting the blood
vessels and bones.
- Nerve function tests. Electromyography (EMG) measures and records
electrical activity in your muscles to find nerve damage. A thin needle (electrode) is
inserted into the muscle to measure electrical activity as you contract the muscle.
During an EMG, a nerve conduction study is typically also done. Flat electrodes are
placed on the skin and a low electric current stimulates the nerves. A health care
professional will record how the nerves respond to the electric current.
- Other nerve function tests. These might include an autonomic reflex
screen. This test records how the autonomic nerve fibers work. Other tests can include a
sweat test that measures your body's ability to sweat and sensory tests that record how
you feel touch, vibration, cooling and heat.
- Nerve biopsy. This involves removing a small portion of a nerve,
usually a sensory nerve, to try to find the cause of the neuropathy.
- Skin biopsy. A small portion of skin is removed to look at the number
of nerve endings.