Khosro Farhad, MD

Peripheral neuropathy is a common neurological disorder and is estimated that more than 20 million Americans are affected. The most common cause is diabetes and pre-diabetes. There are many other known causes of neuropathy, though in many patients the cause remains unknown or idiopathic. Peripheral neuropathy has different types including neuropathies affecting large fibers, small fibers or a combination of both. Patients with large fiber neuropathy primarily present with gait imbalance due to loss of proprioception in their feet and muscle weakness.
 
Patients with small fiber neuropathy primarily present with sensory symptoms such as nerve pain, pins and needles, numbness and discomfort in different areas of the body. These nerves also control autonomic nervous system, which controls automatic and involuntary functions such as heart rate and blood pressure control with standing or exertion, body temperature regulation, sweating, bowel and bladder function and many other organs activities.

At the Center for Peripheral Neuropathy and Autonomic Disorders (CPND), we provide diagnostic tools testing and advanced care for your small fiber neuropathy and autonomic disorders. These tests include:

• Nerve conduction studies and electromyography (EMG) for the diagnosis of large fiber neuropathy.
• Skin biopsy from standard spots in arm or leg for the diagnosis of small fiber neuropathy.
• Standard Autonomic reflex screen, which includes tilt table testing, heart rate and/or blood pressure changes to breathing maneuvers (heart rate variability to deep breathing and Valsalva), measurement of sweating with using QSWEAT® technique, a modified version of QSART (Quantitative Sudomotor Axon Reflex Testing).
• Skin biopsy to look for alpha-synuclein deposition in cutaneous nerves for confirmation of the diagnosis of autonomic disorder caused by Parkinson's Disease, Lewy Body Dementia, Pure Autonomic Failure or Multisystem Atrophy (alpha synucleinopathies).

Related Websites

Autonomic Disorders: Dysautonomia International
Support Group: POTS support group of the Seacoast
Contact: Laura at potsoftheseacoast@yahoo.com