Longitudinal follow-up of biopsy-proven small fiber neuropathy

Muscle Nerve. 2019 Oct;60(4):376-381. doi: 10.1002/mus.26648. Epub 2019 Aug 8.

Abstract

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

Methods: A retrospective analysis of 101 patients with biopsy proven SFN.

Results: 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.

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

Keywords: autonomic dysfunction; gait disorder; intraepidermal nerve fiber density; large fiber neuropathy; neuropathic pain; small fiber neuropathy.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Analgesics / therapeutic use
  • Autonomic Nervous System Diseases / etiology
  • Autonomic Nervous System Diseases / physiopathology*
  • Biopsy
  • Employment*
  • Female
  • Follow-Up Studies
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Mobility Limitation*
  • Neuralgia / drug therapy
  • Neuralgia / etiology
  • Neuralgia / physiopathology*
  • Prognosis
  • Retrospective Studies
  • Small Fiber Neuropathy / complications
  • Small Fiber Neuropathy / pathology
  • Small Fiber Neuropathy / physiopathology*
  • Young Adult

Substances

  • Analgesics