Small fiber peripheral neuropathy

    • Anonymous
      February 9, 2008 at 6:50 am

      I found a reference to this in another article I was reading and was surprised I’ve never heard it mentioned. What do you all think about this?

      [I]Small fiber peripheral neuropathy is a type of 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 is why the symptoms deal with sensation. Usually the symptoms start in the feet and lower legs.

      The symptoms are insensitivity to heat and/or cold, tingling, numbness, muscle weakness, cramps, pain, and other symptoms. People describe the pain as an ice pick being poked into bone, like an electric shock, or walking on broken glass. Sometimes the pain causes a loss in the ability to feel when injury occurs, so one may be bleeding or have a skin injury and not even know it.

      [I]Unfortunately it is a disorder diagnosed by ruling out everything else. In fact, electromyography (EMG tests), which are good in diagnosing other neuropathies are usually not good in detecting small fiber neuropathies. In some cases it can be diagnosed by biopsy, but that would still not affect treatment of the symptoms. Sometimes the disorder is caused by diabetes or alcoholism, but most of the time it is idiopathic. Since there are no known causes for most cases and most tests do not identify it, not much money is spent on curing idiopathic cases.

      There is no current treatment to cure small fiber peripheral neuropathy, but Intravenous immunoglobulin (IVIG) is often used as well as plasmapheresis. For forms caused by diabetes or toxins those underlying condition are treated to reduce progression of the disease and symptoms. For cases without those conditions there is only treatment of the symptoms.[/I][/I]

    • Anonymous
      February 9, 2008 at 4:03 pm

      A good find, Julie. Most likely, SFSN is a part of what happens in GBS. Hence, that is why with so many of us, the emg’s don’t tell the whole story. It makes me wonder when are the docs going to “really listen” to the patient who is doing the experiencing of the disease ~ not just reading a book ?? :rolleyes:

    • Anonymous
      February 9, 2008 at 5:15 pm

      There is a woman on the MGUS forum who has small fiber neuropathy. I believe hers was diagnosed by a biopsy and is associated with her MGUS. Your description is very detailed. Thanks for sharing.

    • Anonymous
      February 9, 2008 at 5:39 pm

      The C fiber mentioned in the article (from Wikipedia) is unmyelinated, so SFPN cannot be a demyelinating disease. Still, I think GBS could damage C fiber nerves. There is evidence that damage to a nerve causes nearby undamaged C fibers to have increased spontaneous activity (reference to a [I]Nature Neuroscience[/I] article found in the Wikipedia article on C fibers). My guess is that the inflammatory response is probably the main mechanism for most people. If GBS also leads to axonal damage, as several variants do, I can see no reason why the damage would not be to all types of axons, C fibers included.

      Yet another reason why figuring out peripheral neuropathy is so difficult.


    • Anonymous
      February 10, 2008 at 12:18 am

      Actually This dx has been brought up more than once with my case. I can tell you it is very difficult to treat, especially when the ncv/emg tests don’t always show everything that is going on or not. Since I haven’t been able to feel pin pricks, some soo hard they left blood, or pinched nails-soooo hard and often that it left my big toes bloody, bruised and broke a nail. The really weird thing with sensory loss is with temperatures-I use to be cold all the time, prior to paralysis and sensory loss, now I can stay out in the cold until I’m told to go in because I feel cold to others who touch me. I can still feel warmth or bonechilling cold on the inside, but its always really slow onset. Like hours after being outside in 20 degree temps and coming in, hours later I would feel extreme cold and pain that would take hours to relieve-I have learned my limits in cold weather.:o
      Is it possible to have GBS/CIDP along with Small Fiber Polyneuropathy? I wish I could come up with some answers to all my questions, but all I have are more questions with no answers.;)