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Small fiber peripheral neuropathy
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'''Small fiber peripheral neuropathy''' or or '''small fiber sensory neuropathy''' or '''SFPN''' or '''small fiber neuropathy''' or '''SFN''' is a type of peripheral neuropathy that occurs from damage to the small unmyelinated<ref>{{Cite news | url=https://medical-dictionary.thefreedictionary.com/unmyelinated | title = unmyelinated|work=TheFreeDictionary.com|access-date=2018-10-04}}</ref> [[Peripheral nervous system|peripheral nerve]]<ref>{{Cite news | url=https://medical-dictionary.thefreedictionary.com/peripheral+nerve | title = peripheral nerve|work=TheFreeDictionary.com|access-date=2018-10-04}}</ref> (any nerve of the [[nervous system]] outside the [[central nervous system]]) fibers. It is common in [[Ehlers-Danlos syndrome|Ehlers-Danlos syndrome]] (EDS),<ref>{{Cite journal | last = Cazzato | first = Daniele | last2 = Castori | first2 = Marco | last3 = Lombardi | first3 = Raffaella | last4 = Caravello | first4 = Francesca| last5 = Bella | first5 = Eleonora Dalla | last6 = Petrucci | first6 = Antonio | last7 = Grammatico | first7 = Paola | last8 = Dordoni | first8 = Chiara | last9 = Colombi | first9 = Marina | date = 2016-06-15 | title = Small fiber neuropathy is a common feature of Ehlers-Danlos syndromes|url=http://n.neurology.org/content/early/2016/06/15/WNL.0000000000002847|journal=Neurology|language=en|pages=10.1212/WNL.0000000000002847|doi=10.1212/WNL.0000000000002847|issn=0028-3878|pmid=27306637}}</ref> [[fibromyalgia]],<ref>{{Cite journal | date = 2013-11-01 | title = Objective evidence that small-fiber polyneuropathy underlies some illnesses currently labeled as fibromyalgia|url=https://www.sciencedirect.com/science/article/pii/S0304395913002947|journal=PAIN®|language=en|volume=154|issue=11|pages=2310–2316|doi=10.1016/j.pain.2013.06.001|issn=0304-3959}}</ref><ref>{{Cite journal | date = 2013-11-01 | title = Objective evidence that small-fiber polyneuropathy underlies some illnesses currently labeled as fibromyalgia|url=https://www.sciencedirect.com/science/article/pii/S0304395913002947|journal=PAIN®|language=en|volume=154|issue=11|pages=2310–2316|doi=10.1016/j.pain.2013.06.001|issn=0304-3959}}</ref><ref>{{Cite journal | last = Levine | first = Todd D. | last2 = Saperstein | first2 = David S. | date = 2014-12-24 | title = Routine use of punch biopsy to diagnose small fiber neuropathy in fibromyalgia patients|url=https://link.springer.com/article/10.1007/s10067-014-2850-5|journal=Clinical Rheumatology|language=en|volume=34|issue=3 | pages = 413–417|doi=10.1007/s10067-014-2850-5|issn=0770-3198|pmid=25535201|via=}}</ref> and [[postural orthostatic tachycardia syndrome]] (POTS).<ref>{{Cite journal | last = Gibbons | first = Christopher H. | last2 = Bonyhay | first2 = Istvan | last3 = Benson | first3=Adam | last4 = Wang | first4 = Ningshan| last5 = Freeman | first5 = Roy | date = 2013-12-27 | title = Structural and Functional Small Fiber Abnormalities in the Neuropathic Postural Tachycardia Syndrome|url=https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0084716|journal=PLoS ONE|language=en|volume=8|issue=12| pages = e84716|doi=10.1371/journal.pone.0084716|issn=1932-6203|pmid=24386408|via=}}</ref> Many other conditions can also cause small fiber peripheral neuropathy such as [[Celiac disease]], [[rheumatoid arthritis]] (RA), [[lyme disease]], [[vitamin B12]] deficiency, and more.<ref name="healthline">{{Cite news | url=https://www.healthline.com/health/small-fiber-neuropathy#symptoms | title = Small Fiber Neuropathy: Symptoms, Treatment, Causes, and More | last = Vandergriendt | first = Carly | date = Jan 4, 2018|work=Healthline|access-date=2018-10-04|archive-url=|archive-date=|url-status= | last2 = Weatherspoon | first2 = Deborah|language=en}}</ref> [[Category:Neurology]] [[Category:Diagnoses]] == Symptoms == <div style="column-count:2;"> * [[Autonomic nervous system|autonomic]] symptoms (Includes many symptoms listed below.) * burning, tingling, prickling ([[paresthesia]]) * [[constipation]] * [[dizziness]] * [[dry eye syndrome|dry eyes]] * [[dry mouth]] * [[incontinence]] * [[Numbness|loss of sensation]] * [[numbness]] * [[Orthostatic intolerance|orthostatic hypotension]], * sexual dysfunction * sharp, shooting pains * skin changes related to interrupted nerve supply (skin discoloration) * [[sweating]] * [[Body temperature|temperature sensitivity]] * or other neuropathic symptoms.<ref name="healthline" /><ref name="webmd">{{Cite web|url=https://www.webmd.com/brain/understanding-peripheral-neuropathy-basics#3 | title = Peripheral Neuropathy -- Symptoms, Types, and Causes of Peripheral Neuropathy | last = | first = | date = |website=WebMD|access-date=2018-10-04|archive-url=|archive-date=|url-status=|language=en-US}}</ref> </div> == Diagnosis == An examination and detailed review of the symptoms, the rate of progression, and complaints suggestive of autonomic fiber involvement are necessary for diagnosis.<ref name="Hovaguimian2011">{{Cite journal | last = Hovaguimian | first = Alexandra | last2 = Gibbons | first2 = Christopher H. | date = 2011 | title=Diagnosis and Treatment of Pain in Small Fiber Neuropathy|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3086960/|journal=Current pain and headache reports|volume=15|issue=3|pages=193–200|doi=10.1007/s11916-011-0181-7|issn=1531-3433|pmid=21286866|via=}}</ref> [[Quantitative sensory testing]] (QST), [[quantitative sudomotor axon reflex testing]] (QSART), skin biopsy, and [[electromyography]] and [[nerve conduction test]]s are useful.<ref name="Hovaguimian2011" /> The Utah Early Neuropathy Scale (UENS) was developed to help diagnosis SFN.<ref>{{Cite journal | last = Singleton | first = J. Robinson | last2 = Bixby | first2 = Billie | last3 = Russell | first3 = James W. | last4 = Feldman | first4 = Eva L. | last5 = Peltier | first5 = Amanda | last6 = Goldstein | first6 = Jonathan | last7 = Howard | first7 = James | last8 = Smith | first8 = A. Gordon | date = 2008 | title = The Utah Early Neuropathy Scale: a sensitive clinical scale for early sensory predominant neuropathy|url=https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1529-8027.2008.00180.x|journal=Journal of the Peripheral Nervous System|language=en|volume=13|issue=3|pages=218–227|doi=10.1111/j.1529-8027.2008.00180.x|issn=1085-9489|via=}}</ref><ref name="Hovaguimian2011" /> The Neuropathic Pain Symptom Inventory (NPSI) can also help.<ref>{{Cite journal | last = Bouhassira | first=Didier | last2 = Attal | first2 = Nadine | last3 = Fermanian | first3 = Jacques | last4 = Alchaar | first4 = Haiel| last5 = Gautron | first5 = Michèle | last6 = Masquelier | first6 = Etienne | last7 = Rostaing | first7 = Sylvie | last8 = Lanteri-Minet | first8 = Michel | last9 = Collin | first9 = Elisabeth | date = 2004 | title=Development and validation of the Neuropathic Pain Symptom Inventory|url=https://www.ncbi.nlm.nih.gov/pubmed/15030944/|journal=Pain|volume=108|issue=3|pages=248–257|doi=10.1016/j.pain.2003.12.024|issn=0304-3959|pmid=15030944|via=}}</ref><ref name="Hovaguimian2011" /> == Treatment == [[Gabapentin]], [[pregabalin]], [[amitriptyline]], [[nortriptyline]], [[Cymbalta|duloxetine]], 5% [[lidocaine]] patch, [[tramadol]], and [[Opioids|opioid]] analgesics are used to treat SFN.<ref>{{Cite web|url=https://www.healthguideinfo.com/neurological-disorders/p86440/ | title = Facts about living with small fiber neuropathy - Also known as C fiber neuropathy or peripheral neuropathy it is often caused by diabetes or classically, Fabry disease | last = Sacks | first = Damon | last2 = Lloyd | first2 = Emma | date = Sep 10, 2010 | website = Health Guide Info|language=en|archive-url=|archive-date=|url-status=|access-date=2018-10-04}}</ref><ref name="hopkins">{{Cite news | url=https://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/peripheral_nerve/conditions/small_fiber_sensory_neuropathy.html | title = Small Fiber Sensory Neuropathy | last = McNamara | first = Lindsay|access-date=2018-10-04|language=en}}</ref><ref name="Hovaguimian2011" /><ref>{{Cite journal | title = Duloxetine for treating painful neuropathy or chronic pain | date = 2009-10-07|url=https://pubmed.ncbi.nlm.nih.gov/19821395/|journal=The Cochrane Database of Systematic Reviews|issue=4|pages=CD007115 | last = Lunn | first = Michael Pt | last2 = Hughes | first2 = Richard Ac | last3 = Wiffen | first3 = Philip J.|doi=10.1002/14651858.CD007115.pub2|pmid=19821395|issn=1469-493X}}</ref> ==See also== ==Learn more== == References == {{reflist}} [[Category:Neurological diseases and disorders]] [[Category:Diagnoses]]
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