Efficacy of High-Frequency Spinal Cord Stimulation in Idiopathic Asymmetrical Small-Fiber Neuropathy Case Report

BACKGROUND: Small-fiber neuropathies (SFNs), affecting thinly myelinated Ad fibers and unmyelinated C fibers, often manifest with sensory or autonomic symptoms in varied patterns. Diagnostic tools comprise skin biopsy, quantitative sensory, autonomic testing, and biochemical markers. Spinal cord stimulation (SCS), particularly high-frequency SCS, has emerged as a pivotal therapeutic intervention. CASE REPORT: This study delves into a 49-year-old woman diagnosed with idiopathic asymmetrical SF peripheral neuropathy, examining her 12-month postoperative trajectory after SCS implantation. Postsurgical assessment revealed substantial improvements: baseline pain (Numeric Rating Scale 7) decreased to 4 at 3 months, indicating reduced intensity; Oswestry Disability Index improved from 38% to 4%, highlighting enhanced functionality; Patient-Specific Questionnaire 3 average score dropped from 35 to 2, indicating improved outcomes in specific pain-related concerns. CONCLUSIONS: This case report underscores the efficacy of SCS in managing idiopathic asymmetrical SFN, demonstrating significant symptomatic relief over a 12-month postoperative period.