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Small fiber peripheral neuropathy is a type of peripheral neuropathy that occurs from damage to the small unmyelinated and myelinated peripheral nerve fibers. These fibers, categorized as C fibers and small Aδ fibers , are present in skin , peripheral nerves , and organs. [ 1 ]
Peripheral neuropathy may be classified according to the number and distribution of nerves affected (mononeuropathy, mononeuritis multiplex, or polyneuropathy), the type of nerve fiber predominantly affected (motor, sensory, autonomic), or the process affecting the nerves; e.g., inflammation (), compression (compression neuropathy), chemotherapy (chemotherapy-induced peripheral neuropathy).
The dorsal root ganglion contains cell bodies for sensory nerves including large, myelinated Aβ fibers which carry proprioception and tactile touch sensation to the brain via the dorsal column–medial lemniscus pathway and small, unmyelinated C fibers which carry thermal and pain sensation to the brain via the spinothalamic tract. [2]
Additionally, BP control in those with diabetes is helpful, while intravenous immunoglobulin is used for multifocal motor neuropathy. [ 1 ] According to Lopate, et al., methylprednisolone is a viable treatment for chronic inflammatory demyelinative polyneuropathy (which can also be treated with intravenous immunoglobulin).
Megavitamin-B 6 syndrome is predominately a large fiber neuropathy characterized by sensory loss of joint position, vibration, and ataxia. [18] [26] Although it has characteristics of small fiber neuropathy in severe cases where there is impairment of pain, temperature, and autonomic functions. [62] [63] [14] [12] [59] [64] [17]
The most useful physical examination finding for large fiber neuropathy is an abnormally decreased vibration perception to a 128-Hz tuning fork (likelihood ratio (LR) range, 16–35) or pressure sensation with a 5.07 Semmes-Weinstein monofilament (LR range, 11–16).
The company prepares to initiate the expected enrollment of patients in the Phase 1/2 study of ST-503 for idiopathic small fiber neuropathy in mid-2025 and file an anticipated Clinical Trial ...
The gold standard for diagnosing small fiber neuropathy as the etiology of neuropathic pain is skin biopsy. Sudomotor assessment, through electrochemical skin conductance, an accurate objective technique, could be considered as a good screening tool to limit skin biopsy in patients in whom it is not suitable. [8] [9]
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