What is small fiber neuropathy?
Small fiber neuropathy is a polyneuropathy isolated to the small nerve fibers, commonly the cutaneous unmyelinated fibers.
The diagnosis can be confirmed with skin biopsy for analysis of nerve fiber density.
What are the symptoms of small fiber neuropathy?
The clinical presentations are quite varied. Some people present with fibromyalgia-like symptoms characterized by diffuse muscle aches.
Others may have burning pain in the limbs or cutaneous insensitivity to painful stimuli.
Some may concomitantly have visceral manifestations of the disease with gastroparesis, bladder dysfunction, chronic general dysmotility of the gastrointestinal tract, and/or orthostatic hypotension secondary to autonomic dysfunction.
Other syndromic manifestations include burning mouth syndrome.
Can small fiber neuropathy be mistaken for fibromyalgia?
Yes. Skin biopsy has uncovered small fiber neuropathy as the driver for symptoms thought to be secondary to fibromyalgia in some cases.