Small fiber peripheral neuropathy

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.

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.