SFN Education & Treatment
Small fiber peripheral neuropathy is a type of peripheral neuropathy. It is also called small fiber neuropathy, small fiber sensory neuropathy (SFSN), and C fiber neuropathy. Small nerve fibers are the nerve fibers near the skin’s surface which created problems with touch, pain, temperature, etc. which is why the symptoms deal with sensation. Usually the symptoms start in the feet and lower legs, although they may begin in the torso or face.
Until relatively recently, this has been a disorder diagnosed mainly by excluding other possibilities. Electromyography (EMG ), a test which is good at diagnosing most forms of neuropathy, is normal in people with small fiber neuropathies. Currently, the small nerve fibers in the skin can be analyzed by means of a simple procedure called a skin biopsy. Sometimes the disorder is caused by diabetes, but, in many patients, no specific cause is identified and the syndrome is termed “idiopathic.”
Small-fiber neuropathy (SFN) is a peripheral nerve disease that causes tingling, numbness and pain. People describe the pain as an ice pick being poked into bone, like an electric shock, or walking on broken glass. SFN does not conform to the typical stocking-glove distribution, and may even involve the face or the trunk.
Small fiber neuropathies can be caused by disorders of metabolism such as diabetes, chronic infections (such as human immunodeficiency virus), genetic abnormalities, toxicity from various drugs, and autoimmune diseases. The cause, however, often remains a mystery. As more research has been developed over the past couple of years, it has become clear that Impaired Glucose Tolerance (IGT) is a frequent cause for small fiber neuropathies.
If a cause for the SFN is identified then there may be treatments to stop progression and even reverse the disease. However a cause is identified only 50% of the time. So in the other cases we have to rely on symptomatic therapy to decrease pain. Antiseizure or antidepressant medications are the most widely used.