I have ANS dysfunction but find my symptoms fluctuate. Severity on a daily basis very influenced by my fatigue, stress , what i eat and other factors such as environmental heat/cold. I monitor my BP, do toxicity test on all foodstuff , note my biorhythms and keep a diary of symptoms/ flares /pain.
Maybe you could keep a record and present your specialist with it
I agree with all of you that small fiber neuropathy is not intermittent, since it involves degeneration of small nerve fibers. But EM symptoms can be continuous and intermittent. I suffered continuous flaring before sodium channel blockers.
Many cases of EM and Raynauds found linked to SFN. Current research shows this to be the case - especially primary .
Ill upload research on this for us when you post topic ;)
I was diagnosed SFN through the sweat test, QST and skin biopsy in UK
EM/ Raynauds was diagnosed by quantitative sensory testing (QST)( thermal test ) , and skin biopsy (heat allergy/chronic urticuaria),a pain/symptom diary and mountain of photos. I also induced a flare in front of their eyes- was wonderful to behold the shock ;)
The cornell lab in ny is where they sent my skin biopsy and that is the only lab that has a normative data collection. They compare your sample to others that are the same age and sex. Em I was told was diagnosed by a history exam findings. And that is a symptom not a disease.
A specialized skin biopsy and an autonomic function test was used for diagnosis. Here is a good article about it. Good luck. Let me know how you make out! http://m.ccjm.org/content/76/5/297.full