TY - JOUR
T1 - Clinical diagnosis and management of small fiber neuropathy
T2 - an update on best practice
AU - Devigili, Grazia
AU - Cazzato, Daniele
AU - Lauria, Giuseppe
N1 - Funding Information:
This paper was not funded.
Publisher Copyright:
© 2020, © 2020 Informa UK Limited, trading as Taylor & Francis Group.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020
Y1 - 2020
N2 - Introduction: Small fiber neuropathy (SFN) is a heterogeneous group of disorders affecting thinly myelinated Aδ and unmyelinated C-fibers. Common symptoms include neuropathic pain and autonomic disturbances, and the typical clinical presentation is that of a length-dependent polyneuropathy, although other distributions could be present. Area covered: This review focuses on several aspects of SFN including etiology, clinical presentation, diagnostic criteria and tests, management, and future perspectives. Diagnostic challenges are discussed, encompassing the role of accurate and standardized assessment of symptoms and signs and providing clues for the clinical practice. The authors discuss the evidence in support of skin biopsy and quantitative sensory testing as diagnostic tests and present an overview of other diagnostic techniques to assess sensory and autonomic fibers dysfunction. The authors also suggest a systematic approach to the etiology including a set of laboratory tests and genetic examinations of sodium channelopathies and other rare conditions that might drive the therapeutic approach based on underlying cause or symptoms treatment. Expert opinion: SFN provides a useful model for neuropathic pain whose known mechanisms and cause, could pave the way towards personalized treatments.
AB - Introduction: Small fiber neuropathy (SFN) is a heterogeneous group of disorders affecting thinly myelinated Aδ and unmyelinated C-fibers. Common symptoms include neuropathic pain and autonomic disturbances, and the typical clinical presentation is that of a length-dependent polyneuropathy, although other distributions could be present. Area covered: This review focuses on several aspects of SFN including etiology, clinical presentation, diagnostic criteria and tests, management, and future perspectives. Diagnostic challenges are discussed, encompassing the role of accurate and standardized assessment of symptoms and signs and providing clues for the clinical practice. The authors discuss the evidence in support of skin biopsy and quantitative sensory testing as diagnostic tests and present an overview of other diagnostic techniques to assess sensory and autonomic fibers dysfunction. The authors also suggest a systematic approach to the etiology including a set of laboratory tests and genetic examinations of sodium channelopathies and other rare conditions that might drive the therapeutic approach based on underlying cause or symptoms treatment. Expert opinion: SFN provides a useful model for neuropathic pain whose known mechanisms and cause, could pave the way towards personalized treatments.
KW - autonomic disorders
KW - neuropathic pain
KW - painful evoked potentials
KW - Quantitative sensory testing
KW - skin biopsy
KW - Small Fiber Neuropathy
KW - sodium channelopathy
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U2 - 10.1080/14737175.2020.1794825
DO - 10.1080/14737175.2020.1794825
M3 - Review article
C2 - 32654574
AN - SCOPUS:85087876610
JO - Expert Review of Neurotherapeutics
JF - Expert Review of Neurotherapeutics
SN - 1473-7175
ER -