Longitudinal follow-up of biopsy-proven small fiber neuropathy

Little is published on the prognosis of small fiber neuropathy (SFN).

A retrospective analysis of 101 patients with biopsy proven SFN.

Study participants included 87 patients with length-dependent SFN and 14 patients with non-length-dependent SFN. The average duration of symptoms was 3.2 years prior to SFN diagnosis, and the average follow-up duration after diagnosis was 6.2 years. Neuropathic pain was present in 98% of patients and in 84.2% of patients at the final visit. The average total number of pain medications ever used was 4.4 per patient. Signs of autonomic dysfunction were initially present in 24.8% of patients, but improved in most. Large fiber involvement was seen in 11.9% of patients. Small fiber neuropathy affected employment and ambulation status in 5.3% and 6.3% of patients, respectively.

Small fiber neuropathy tends to be stable and rarely affects ambulation and employment status. Effective pain control remains a challenge.