What is small fiber neuropathy?
Small fiber neuropathy affect the small myelinated A δ and unmyelinated C fibers.
Symptoms usually consist of pain, numbness, burning, “pins and needles-like” sensations, and autonomic disturbances.
On examination, patients may have decreased pinprick and temperature sensation with allodynia and hyperalgesia.
Most patients will have normal sensory nerve conduction studies with a pure small fiber neuropathy and may have an abnormal Quantitative Sensory Testing.
The most common etiologies are diabetes, genetic including amyloidosis, and idiopathic.