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Related Experiment Videos

Review: small-fiber neuropathy.

Amer Al-Shekhlee1, Thomas C Chelimsky, David C Preston

  • 1Department of Neurology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio 44016-5098, USA.

The Neurologist
|June 14, 2003
PubMed
Summary

Small-fiber neuropathies are rare but diverse disorders affecting pain and autonomic functions. Diagnosis requires specialized testing beyond standard nerve conduction studies, with management often focusing on symptom relief.

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Area of Science:

  • Neurology
  • Clinical Neuroscience
  • Peripheral Nervous System Disorders

Background:

  • Most peripheral neuropathies affect both large and small nerve fibers.
  • A distinct subset involves primarily small-fiber dysfunction, presenting unique diagnostic challenges.

Purpose of the Study:

  • To review the differential diagnosis, clinical presentation, evaluation, and treatment of small-fiber neuropathies.
  • To highlight the diagnostic difficulties due to normal electrodiagnostic findings in some cases.

Main Methods:

  • Review of literature on small-fiber neuropathies.
  • Discussion of diagnostic modalities including autonomic function tests, intraepidermal nerve fiber analysis, and quantitative sensory testing.

Main Results:

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  • Small-fiber neuropathies have a broad differential diagnosis, encompassing metabolic, toxic, inflammatory, infectious, and genetic causes.
  • Symptoms typically include pain, temperature loss, and autonomic dysfunction.
  • Standard nerve conduction studies and EMG are often normal, necessitating specialized investigations.

Conclusions:

  • Small-fiber neuropathies are a heterogeneous group of rare disorders.
  • Diagnosis can be extensive and may require pathological specimens.
  • Management often involves symptomatic treatment, though some cases are challenging to treat.