What Are The Chances Of Neuropathy When The Nerve And Muscle Test Results Are Normal?

Question : HI,The nerve & muscle test was normal. I don't have a copy of the results but can get it later. However, after I returned home, I did some research and discovered that small fibre neuropathies often do not show up on these tests and since I do an assymetric distribution patter (dysthesia - burning or coolness) with a predominance in the arms, I think that I may get some v bad news (paraneoplastic syndrome) once all of the necessary tests are done. The chest x-ray was repeated last week and nothing was found but from what I read, that is not at all uncommon with this type of disease. I have checked for all of the other types of neuropathy and nothing else seems to fit. I believe that radiculopathies almost always produce numbness or some motor deficit. I previously had an MRI (multi-level degenerative disc disease & multi-level right foraminal stenosis which I was also told would not produce the symptoms that I have.) I have an appointment with an internist on Monday. I am v scared.

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I cannot thank you enough for your vigilant response. I just had a pin-prick type of test the other day and the results were totally abnormal -- one side was different from the other in numerous places in my legs and arms all the way up to my head. The new neurologist did not do further testing because he wants to see all of my previous records first. I am very frustrated because he does not have another appointment for me until XXXXXXX 19th. (and I really do feel that time is of the essence and they are taking so long) I think I should have an FDG-PET scan asap but it appears almost impossible to get one now--I am going out tomorrow to try. (not sure what you would think of this but I feel that I must rush things along) I also have to fax in a referral for a rheumatologist but this may also take a few months according to the secretary, depending upon how urgent they think my case is. I can try to see someone else sooner, esp for the autoimmune antibodies tests. I feel like I must hurry-- there is this sense that my life could be in grave danger. (a year and three months has already gone by and everyone seems to be quite indifferent to the situation at hand---I feel like I am just another number going through the system at a time when something much more is warranted) I will try and get the information that you requested within the next week or so--as soon as I can. My arms, back and legs are freezing in particular areas--what is most disarming to me is that the symptoms are always there (more predominant in the arms -- appears to be worse while I am sitting.) I am afraid that I could develop encephalitis or suffer some other neurological side-effect. I also keep remembering that the post menopausal bleeding occured a month and a half after the sudden onset of these neuropathic-like symptoms--hence, the strong suspicion of an autoimmune type of paraneoplastic syndrome. (I know that it is more likely to be associated with lung than gynecological cancer so that could also be another grim possibility) I had read online that small fibre sub-acute sensory neuropathy could also be associated with this syndrome in the assymetric fashion but now you have at least provided me with some counter-balance which is no doubt based upon your professional knowledge and experience. I just got a call a few weeks ago telling me that they have discovered abnormal cells in my uterus afterall. (the results showed no cancer at Christmas time but now they are going to do another biopsy. I had an operation to remove a very large endometrial polyp in November. (the hospital is moving to a new location so they will be following up with me sometime in May) Thanks again. I truly value your wisdom and perspective------will be in touch as soon as I have the info that you requested.

Small fibre neuropathies are also associated with more intense burning and coldness which correlates. The abnormal pin-prick results are also indicative of a neuropathy, are they not?

Thank-you for your wonderful follow-up. I will be in touch.