Punch nerve biopsy

[Cassi307]

My rheum has referred me to an MDS for my tremors and suggested a punch biopsy for my neuropathy. Is there any value to doing the biopsy? Does it ever show anything?

Right now I am on Lyrica for the still mild pins and needles feeling in my hand and arm and I have a burning pain in all my fingertips and toes. The finger and toe pain cause most of the discomfort. I don't want to go through the expense and discomfort if it isn't going to change anything.

What is your experience?

[cccourt1942]

I had this done, 10 or 11 years ago.  I don't recall it being referred to as punch "nerve" biopsy.  The purpose of mine was for dx of psoriasis.  It was done in my leg...and when I saw the size of the instrument I actually asked what it was for.  It smarted (it had been deadened.)  Then they  took a couple of stitches.  That's all.   Mine may be all together different from yours since it isn't specifically for a skin disease. 

Hope all goes well for you .   

[anita]

The 'punch' nerve biopsy is also called a skin biopsy. It checks the small nerve fibers that cannot be checked on EMG or nerve conduction studies.  The biopsy IS VERY helpful in diagnosing small fiber neuropathy...actually it is the only test to properly diagnose it.

The biopsy is very simple and minimally invasive.  Small little 'punches' of skin are taken and sent to the pathologist.  Only need for a bandaid and minor care post biopsy.

The test can also be repeated many times over the years so it can track progression of neuropathy and also see if treatment is improving it.

I would suggest you go for it if you have neuropathy symptoms and ENG was negative.

[wifey1]

Ditto what Anita said...I had a skin biopsy done a couple weeks ago.  The most painful part was the numbing shots!  Otherwise, no big deal.  My sites - 4 of them - healed enough in a week or so to not need bandaids. 

Mine ended up showing that I don't have nerve damage.  That was discouraging at first - why don't I have damage if I have so many pins and needles, burning pain, etc? - but then my doctor reoriented me to the fact that if no damage is present yet, that means there's the potential for me getting some symptomatic relief.  And again, like Anita said, now they have something to compare to down the road...

[Cassi307]

Thanks everyone. My concern was that they may write off my complaints if it turned out negative. I had a punch biopsy once before for a suspicious growth and the PA who did it messed me up and it became infected large scar. I didn't want to go through that again.