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Small-fiber neuropathy definition, diagnosis, and treatment

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Abstract

In the last 30 years, improvement of diagnostic methods enabled routine evaluation of small A-delta and C nerve fibers impairment, which results with the clinical condition known as a small-fiber neuropathy (SFN). This syndrome develops as a result of metabolic, toxic, immune-mediated, or genetic factors. The main clinical features include neuropathic pain and autonomic disturbance, which are occasionally disclaimed due to outstanding fatigue, daily performance decline, anxiety, and depression. As clinical, neurological, nerve conduction, and electromyography studies are commonly normal, diagnosis often depends on the finding of decreased intra-epidermal density of nerve fibers, per skin biopsy. This review highlights the etiology, clinical, diagnostic aspects, and SFN treatment.

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Funding

This work is supported by the grant of the Government of the Russian Federation for the state support of scientific research carried out under the supervision of leading scientists, agreement 14.W03.31.0009, on the basis of SPbU projects of 13.02. 2017.

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Authors and Affiliations

  1. Laboratory of the Mosaic of Autoimmunity, Federal State Budget Educational Institution of Higher Education “St. Petersburg State University”, University Emb., 7-9, Saint-Petersburg, Russia, 199034

    Natalia Y. Basantsova, Anna A. Starshinova, Yulia S. Zinchenko, Piotr K. Yablonskiy & Yehuda Shoenfeld

  2. Department of Faculty Therapy, Federal State Budget Educational Institution of Higher Education “St. Petersburg State University”, University Emb., 7-9, Saint-Petersburg, Russia, 199034

    Natalia Y. Basantsova

  3. Ministry of Health of Russian Federation, Federal State Budgetary Institution “St. Petersburg Research Institute of Phthisiopulmonology”, St. Petersburg, Russia

    Natalia Y. Basantsova, Yulia S. Zinchenko & Piotr K. Yablonskiy

  4. Department of Neurology, Talpiot Medical Leadership Program, Chaim Sheba Medical Center, 52621, Tel Ha Shomer, Israel

    Amir Dori

  5. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Amir Dori & Yehuda Shoenfeld

  6. Zabludowicz Center for Autoimmune Diseases, Chaim Sheba Medical Center, 52621, Tel Ha Shomer, Israel

    Yehuda Shoenfeld

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  1. Natalia Y. Basantsova
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  2. Anna A. Starshinova
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  3. Amir Dori
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  4. Yulia S. Zinchenko
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Correspondence to Anna A. Starshinova.

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Basantsova, N.Y., Starshinova, A.A., Dori, A. et al. Small-fiber neuropathy definition, diagnosis, and treatment. Neurol Sci 40, 1343–1350 (2019). https://doi.org/10.1007/s10072-019-03871-x

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