Definition
The small fiber neuropathies are a group of disorders of diverse etiologies that have predominant involvement of Aδ and C-fibers, with consequent impairment of nociception, variable degrees of autonomic dysfunction, and frequently neuropathic pain.
Characteristics
The “small fibers” of the PNS include the Aδ and C sensory fibers, the γ efferent fibers, and the preganglionic parasympathetic and postganglionic sympathetic C-fibers. In contrast, the large fibers of the PNS include the Aβ afferents from skin, muscle, and the internal organs, as well as the α motor neurons. Most disorders of the PNS are characterized by distally predominant loss of axons, a process often referred to as distal axonal degeneration or “dying back.” Distal axonal degeneration affects long fibers before shorter ones, with the distal-most regions of the long axons underlying pathologic changes that closely resemble Wallerian degeneration following axonal injury. With time, the process moves proximally...
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References
Diem, P., Laederach-Hofmann, K., Navarro, X., Mueller, B., Kennedy, W. R., & Robertson, R. P. (2003). Diagnosis of diabetic autonomic neuropathy: A multivariate approach. European Journal of Clinical Investigation, 33, 693–697.
Dyck, P. J. B., & Dyck, P. J. (1999). Diabetic polyneuropathy. In P. J. Dyck & P. K. Thomas (Eds.), Diabetic neuropathy (pp. 255–278). Philadelphia: W.B.Saunders.
Herrmann, D. N., Griffin, J. W., Hauer, P., Cornblath, D. R., & McArthur, J. C. (1999). Epidermal nerve fiber density and sural nerve morphometry in peripheral neuropathies. Neurology, 53, 1634–1640.
Holland, N. R., Crawford, T. O., Hauer, P., Cornblath, D. R., Griffin, J. W., & McArthur, J. C. (1998). Small-fiber sensory neuropathies: Clinical course and neuropathology of idiopathic cases. Annals of Neurology, 44, 47.
Kennedy, W. R. (2002). Usefulness of the silicon impression mold technique to evaluate sweating. Clinical Autonomic Research, 12, 9–10.
Kennedy, W. R., & Wendelschafer-Crabb, G. (1994). Quantification of nerve in skin biopsies from control and diabetic subjects. Neurology, 44, A275.
Low, P. A. (1990). The effect of aging on cardiac autonomic and post ganglionic sudomotor function. Muscle & Nerve, 13, 152–157.
McArthur, J. C., Stocks, A., Hauer, P., Cornblath, D. R., & Griffin, J. W. (1998). Epidermal nerve fiber density: Normative reference range and diagnostic efficiency. Archives of Neurology, 55, 1513–1520.
Orstavik, K., Weidner, C., Schmidt, R., Schmelz, M., Hilliges, M., Jorum, E., Handwerker, H., & Torebjork, E. (2003). Pathological C-fibres in patients with a chronic painful condition. Brain, 126, 567–578.
Periquet, M. I., Novak, V., Collins, M. P., Nagaraja, H. N., Erdem, S., Nash, S. M., Freimer, M. L., Sahenk, Z., Kissel, J. T., & Mendell, J. R. (1999). Painful sensory neuropathy: Prospective evaluation using skin biopsy. Neurology, 53, 1641–1647.
Raja, S. N., Haythornthwaite, J. A., Pappagallo, M., Clark, M. R., Travison, T. G., Sabeen, S., Royall, R. M., & Max, M. B. (2002). Opioids versus antidepressants in postherpetic neuralgia: A randomized, placebo-controlled trial. Neurology, 59, 1015–1021.
Sindrup, S. H., & Jensen, T. S. (2000). Pharmacologic treatment of pain in polyneuropathy. Neurology, 55, 915–920.
Singleton, J. R., Smith, A. G., & Bromberg, M. B. (2001). Painful sensory polyneuropathy associated with impaired glucose tolerance. Muscle & Nerve, 24, 1225–1228.
Sumner, C. J., Sheth, S., Griffin, J. W., Cornblath, D. R., & Polydefkis, M. (2003). The spectrum of neuropathy in diabetes and impaired glucose tolerance. Neurology, 60, 108–111.
Yang, Y., Wang, Y., Li, S., Xu, Z., Li, H., Ma, L., Fan, J., Bu, D., Liu, B., Fan, Z., Wu, G., Jin, J., Ding, B., Zhu, X., & Shen, Y. (2004). Mutations in SCN9A, encoding a sodium channel alpha subunit, in patients with primary erythermalgia. Journal of Medical Genetics, 41, 171–174.
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Griffin, J.W. (2013). Small Fiber Neuropathies. In: Gebhart, G.F., Schmidt, R.F. (eds) Encyclopedia of Pain. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-28753-4_4033
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DOI: https://doi.org/10.1007/978-3-642-28753-4_4033
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-28752-7
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