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Related Experiment Video

Updated: Sep 25, 2025

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[Small fiber neuropathy diagnosis].

Marie Théaudin1, François Ochsner1, Clovis Adam2

  • 1Service de neurologie, Département des neurosciences cliniques, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne.

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|April 28, 2022
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Summary

Small fiber neuropathies impact sensory and autonomic nerve fibers, often causing neuropathic pain. Diagnosis relies on specific tests when standard nerve studies are normal, but the cause remains unknown in many cases.

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Area of Science:

  • Neurology
  • Neuroscience
  • Pain Medicine

Background:

  • Small fiber neuropathies (SFN) involve small, unmyelinated C and thinly myelinated Aδ nerve fibers.
  • Neuropathic pain is a primary symptom of SFN.
  • Diagnosis requires identifying sensory or autonomic deficits with normal conventional nerve conduction studies.

Purpose of the Study:

  • To summarize diagnostic approaches for small fiber neuropathies.
  • To highlight the range of diagnostic tests available.
  • To discuss the etiologies and idiopathic nature of SFN.

Main Methods:

  • Review of diagnostic criteria for SFN.
  • Description of various diagnostic tests including sympathetic skin response and skin biopsy.
  • Analysis of etiological factors and diagnostic challenges.

Main Results:

  • Diagnostic confirmation relies on specific tests like skin biopsy to assess intraepidermal nerve fiber density.
  • Test availability and utility vary across medical centers.
  • Acquired and genetic causes exist, but over half of SFN cases are idiopathic.

Conclusions:

  • Small fiber neuropathy diagnosis is confirmed by specific tests when standard neurography is normal.
  • A significant proportion of small fiber neuropathies lack an identifiable cause.
  • Further research is needed to understand and manage idiopathic SFN.