Back To The Sweat Test...

[erikainorlando]

OK.

Does the sweat test indicate autonomic nerve damange?

The infamous doc I saw blamed all my POTS on the damage I had from Guillain Barre. But I didn't have POTS until 8+ years after the GBS....so I am trying to figure all this out. It was again after a virus and took 5 months to get diagnosed.

Sweat Test Results: Anormal Study. Response latencies were prolonged in the proximal leg and foot. The response latency was shortened in the distal leg. All response volumes were normal. She adds that this may be consistent with patchy periperal small fiber dysfunction.

What does this mean??

Thanks guys!!!

Erika

[arizona girl]

Erika, Nunntrio asked the same question under the post "Sweat test question?" Can you go read what I wrote there so I don't have to type it again.

The short answer is yes small fiber damage can cause autonomic neuropathy. GBS can also cause it as well as motor (large fiber) function nerve damage. It would explain pots symptoms, but not your inability to walk when your upright, that would be large fiber. You probably have nerve damage in both types of nerves. How much research have you done on GBS, as it can have longer lasting effects even after you have recovered from the initial episode. I wouldn't dismiss it as a possible cause for your symptoms today.

There is a simple non subjective test for small fiber that is better then the sweat test to determine if you have it. It is a skin biopsy to look for small fiber nerve damage, it also looks for other damage too.

I had this test without having sweat testing and I do have small fiber. I have many autonomic and pain symptoms, but I can still walk. I do get a little bit jittery or sweaty if I'm upright to long, or talk to much because my body is pumping out excessive norepinepherine to compensate. Have they measured your supine and standing cathecholimines yet?

You might want to find a neurologist that specializes in skin biopsy for small fiber, they will have a better understanding of these types of neuropathies. There are many neurological disorders that are more common that neurologists base their practices around, which narrows there focus. This is less common, so you need to find a neurologist that specializes in this area. I'm lucky to have one here in phoenix. They may be able to refer you to someone in your area.

Also if you think that psych evaluation was wrong, then you should challenge it. Submit a letter to that doctor to be added to your medical record stating that you disagree and why. Really other then an observation what other type of psych evaluation did they do on you to confirm it. Seems pretty flimsy to me. Plus you said you had a psych evaluation by some one who already said that wasn't the problem, submit documented notes from that doc as well, and file a complaint with the hospital and medical board. You can't let those notes stand in your medical record, as it will color any future diagnostics. Of course, if you have copies of everything, then I would leave those particular doctor's notes out before giving them to any new doc. They are too busy to go getting copies from your other doctors, if you are nice enough to provide them yourself.

[erikainorlando]

Thank you so much. It just seems like there is so much confusion in these areas. I guess for me as well all my previous nerve damage does color the issue....but I never had autonomimc problems with the Guillain Barre. Even after months laying flat...I just popped up with many other issues but hr and all was fine.

But do you understand what the diagnositic info means... the latency periods etc.?

[arizona girl]

Yes, it just means that those locations didn't sweat in the normally expected time. Which suggest that there is nerve damage, mainly small fiber. The skin biopsy is now the gold standard to prove small fiber damage.