Small fiber neuropathy: a common and important clinical disorder

J Neurol Sci. 2004 Dec 15;227(1):119-30. doi: 10.1016/j.jns.2004.08.012.


Small fiber neuropathy (SFN) is a neuropathy selectively involving small diameter myelinated and unmyelinated nerve fibers. Interest in this disorder has considerably increased during the past few years. It is often idiopathic and typically presents with peripheral pain and/or symptoms of autonomic dysfunction. Diagnosis is made on the basis of the clinical features, normal nerve conduction studies (NCS) and abnormal specialized tests of small nerve fibers. Among others, these tests include assessment of epidermal nerve fiber density, temperature sensation tests for sensory fibers and sudomotor and cardiovagal testing (QSART) for autonomic fibers. Unless an underlying disease is identified, treatment is usually symptomatic and directed towards alleviation of neuropathic pain.

Publication types

  • Review

MeSH terms

  • Autonomic Nervous System Diseases / diagnosis
  • Autonomic Nervous System Diseases / etiology*
  • Autonomic Nervous System Diseases / therapy
  • Cytokines / metabolism
  • Evoked Potentials / physiology
  • Humans
  • Ischemia / complications
  • Nerve Fibers / classification
  • Nerve Fibers / pathology*
  • Neuralgia / diagnosis
  • Neuralgia / etiology*
  • Neuralgia / therapy
  • Oxidative Stress / physiology
  • Peripheral Nervous System Diseases / complications*
  • Peripheral Nervous System Diseases / diagnosis
  • Peripheral Nervous System Diseases / etiology
  • Peripheral Nervous System Diseases / therapy
  • Sensory Thresholds / physiology


  • Cytokines