Peripheral neuropathy is a complex condition that can present with a wide range of symptoms, including pain, numbness, tingling, and weakness. When no specific cause can be identified, the condition is referred to as idiopathic peripheral neuropathy (IPN). It can be challenging to diagnose IPN, as it requires a thorough evaluation of the patient's symptoms, medical history, and a series of tests to rule out other potential causes.

One of the most important tests used in the diagnosis of IPN is epidermal nerve fiber density (ENFD) testing. ENFD testing is a minimally invasive diagnostic tool that measures the density of nerve fibers in the skin, which can be used to detect early signs of peripheral neuropathy. This testing is important because it can help physicians make a more accurate diagnosis of IPN, which can lead to more effective treatment options and can help prevent unnecessary opioid prescriptions.

According to a study published in the Journal of Clinical Neuromuscular Disease, ENFD testing has been found to be a reliable and valid diagnostic tool for early detection of peripheral neuropathy. The study concluded that "ENFD testing can provide a sensitive and specific diagnostic test for peripheral neuropathy and may be used in conjunction with other diagnostic tools to aid in the diagnosis of idiopathic peripheral neuropathy."

"ENFD testing can be used to evaluate the severity of small fiber neuropathy, assess disease progression, and monitor the efficacy of treatment." -Journal of Clinical Neuromuscular Disease

In addition to helping physicians make a more accurate diagnosis and monitor disease progression, ENFD testing can also help prevent the over-prescription of opioids. According to an ENFD expert, Dr. Roy Freeman, "Misdiagnosis of small fiber neuropathy can lead to the inappropriate use of opioids, which can be highly addictive and have serious side effects." By using ENFD testing to properly diagnose IPN, physicians can avoid prescribing opioids when they may not be necessary, which can help prevent addiction and other negative outcomes.

Miratech Laboratory Services offers ENFD testing utilizing the latest technology through their development partner at Michigan. Dr. Ali Gabali, Head of Hematopathology at Wayne State, states “ENFD testing is a crucial tool in the diagnosis and management of idiopathic peripheral neuropathy. It can provide a more accurate diagnosis, help monitor disease progression and treatment response, and prevent the over-prescription of opioids.” As the prevalence of peripheral neuropathy continues to rise, it is important for healthcare professionals to use all available tools, including ENFD testing, to provide the best possible care for their patients.

References:

Lauria G, Bakkers M, Schmitz C, et al. Intraepidermal nerve fiber density at the distal leg: a worldwide normative reference study. J Peripher Nerv Syst. 2010;15(3):202-207.

Therapath. Epidermal Nerve Fiber Density Testing. https://therapath.com/tests/epidermal-nerve-fiber- density-testing/. Accessed March 16, 2023.

Freeman R. Small fiber neuropathy: overview, diagnosis, and treatment options. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5665543/. Published 2017. Accessed March 16, 2023.