RT Journal Article
SR Electronic
T1 Small fiber neuropathy: A burning problem
JF Cleveland Clinic Journal of Medicine
JO Cleve Clin J Med
FD Cleveland Clinic
SP 297
OP 305
DO 10.3949/ccjm.76a.08070
VO 76
IS 5
A1 Jinny Tavee
A1 Lan Zhou
YR 2009
UL http://www.ccjm.org/content/76/5/297.abstract
AB Small fiber neuropathy is increasingly being recognized as a major cause of painful burning sensations in the feet, especially in the elderly. Although strength remains preserved throughout the course of the disease, the pain and paresthesias are often disabling. Diabetes mellitus is the most common identifiable cause of small fiber neuropathy, and impaired oral glucose tolerance and individual components of the metabolic syndrome are often associated with it. Some cases, however, are idiopathic. Skin biopsy (with an evaluation of the density of intraepidermal nerve fibers) and tests of autonomic nerve function are useful for the diagnosis. Management involves controlling pain and identifying and aggressively treating the underlying cause.