Skin biopsy: a new tool for diagnosing peripheral neuropathy

[Guest guest]

BMJ 2007;334:1159-1162 2 June

Skin biopsy: a new tool for diagnosing peripheral neuropathy

Giuseppe Lauria, consultant, Raffaella Lombardi, neurobiologist

Neuromuscular Diseases Unit, National Neurological Institute " Carlo

Besta " , 20133, Milan, Italy

Extract:

The prevalence of peripheral neuropathy is about 2% in the general

population, but it rises to 12% and 17% in people with one or two

recognised risk factors.1 Diabetes is one such risk factor and the

most common cause of this disorder—about half of patients who have

had diabetes for 25 years have peripheral neuropathy. The early

symptoms of diabetic neuropathy and other peripheral neuropathies

are due to degeneration of small somatic nerve fibres, which may

remain the only nerves involved.2 However, " small fibre neuropathy "

may not be detected by traditional physical, neurophysiological, and

neuropathological tests. In the past decade, skin biopsy has become

a popular method for investigating small nerve fibres.3 It allows

general practitioners and non-specialists—such as diabetologists and

specialists in orthopaedics—to diagnose neuropathy (thereby avoiding

delayed or incorrect diagnosis), to investigate its aetiology, and

to focus treatment, in particular for neuropathic pain.

http://www.bmj.com/cgi/content/short/334/7604/1159

[Guest guest]

Hello Gretchen,

Dr.Shy was working on this when I was out to Detroit for new AFOs.

He took samples from the thumb side of my index finger. It is supposed

to be working towards a much less costly diagnostic tool.

I've been much behind on e-mails due to the heart atack I had three

months ago. Rehab is doing well and I've added two new stents to the

collection of hardware in the old Bod.

EdM from NH