Small-Fiber Neuropathy — A Case Series

Small-fiber neuropathy is characterized by neuropathic-type pain; abnormal sensation to pinprick, heat, or cold; and autonomic dysfunction — but no motor weakness, and normal proprioception and vibratory sensation. Nerve conduction studies and electromyography are normal. In this report, Mayo Clinic researchers present a series of 94 patients with pure small-fiber neuropathy (i.e., no evidence of large-fiber neuropathy at time of presentation). All patients had one or more positive confirmatory tests (e.g., thermoregulatory sweat test, quantitative sensory testing, skin biopsy to measure intraepidermal nerve fiber density).

Median patient age was 54, and mean body-mass index was 30.4 kg/m². Nearly all patients had cutaneous neuropathic pain …