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Chapter-019 Small Fiber Neuropathy

BOOK TITLE: Ramamurthy's Decision Making in Pain Management: An Algorithmic Approach

Author
1. R Bhavaraju-Sanka
ISBN
9789386261458
DOI
10.5005/jp/books/14128_20
Edition
3/e
Publishing Year
2018
Pages
4
Author Affiliations
1. UT Health San Antonio, San Antonio, TX, USA
Chapter keywords
Small fiber neuropathy, myelinated A delta fiber, Aδ fiber, electrodiagnostic testing, neurological examination, IENFD, QSART, quantitative sensory testing

Abstract

Small fiber neuropathy is defined as a disorder of sensory nerves caused by abnormalities in thinly myelinated A delta fiber (Aδ) and unmyelinated C nerve fibers. It causes a painful neuropathy that can be difficult to diagnose. Recent electrophysiological and histological methods have been developed to help improve the diagnosis. Treatment of small fiber neuropathy is symptomatic unless an underlying cause is found. Medications currently available can reduced the pain between 20–40%. Patient should be made aware of this, so realistic goals and expectations can be set. Medications include anticonvulsants, tricyclic antidepressants, serotonin norepinephrine reuptake inhibitors, sodium channel blockers, opioids and others.

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