Skip to main content
Erschienen in: Current Pain and Headache Reports 6/2022

06.04.2022 | Neuropathic Pain (A Abd-Elsayed, Section Editor)

Small Fiber Neuropathy

verfasst von: N. Strand, C. Wie, J. Peck, M. Maita, N. Singh, J. Dumbroff, V. Tieppo Francio, M. Murphy, K. Chang, D. M. Dickerson, J. Maloney

Erschienen in: Current Pain and Headache Reports | Ausgabe 6/2022

Einloggen, um Zugang zu erhalten

Abstract

Purpose of Review

This narrative review aims to summarize advances in the field of small fiber neuropathy made over the last decade, with emphasis on novel research highlighting the distinctive features of SFN.

Recent Findings

While the management of SFNs is ideally aimed at treating the underlying cause, most patients will require pain control via multiple, concurrent therapies. Herein, we highlight the most up-to-date information for diagnosis, medication management, interventional management, and novel therapies on the horizon.

Summary

Despite the prevalence of small fiber neuropathies, there is no clear consensus on guidelines specific for the treatment of SFN. Despite the lack of specific guidelines for SFN treatment, the most recent general neuropathic pain guidelines are based on Cochrane studies and randomized controlled trials (RCTs) which have individually examined therapies used for the more commonly studied SFNs, such as painful diabetic neuropathy and HIV neuropathy. The recommendations from current guidelines are based on variables such as number needed to treat (NNT), safety, ease of use, and effect on quality of life.
Literatur
7.
Zurück zum Zitat • Terkelsen AJ, Karlsson P, Lauria G, Freeman R, Finnerup NB, Jensen TS. The diagnostic challenge of small fibre neuropathy: clinical presentations, evaluations, and causes. Lancet Neurol. 2017;16(11):934–44. https://doi.org/10.1016/S1474-4422(17)30329-0. This manuscript reviews the clinical presentation of small fiber neuropathy and offers a comprehensive view of evaluation of this condition that would be useful for the pain medine. • Terkelsen AJ, Karlsson P, Lauria G, Freeman R, Finnerup NB, Jensen TS. The diagnostic challenge of small fibre neuropathy: clinical presentations, evaluations, and causes. Lancet Neurol. 2017;16(11):934–44. https://​doi.​org/​10.​1016/​S1474-4422(17)30329-0. This manuscript reviews the clinical presentation of small fiber neuropathy and offers a comprehensive view of evaluation of this condition that would be useful for the pain medine.
13.
Zurück zum Zitat Lauria G, Hsieh ST, Johansson O, Kennedy WR, Leger JM, Mellgren SI, et al. European Federation of Neurological Societies/Peripheral Nerve Society Guideline on the use of skin biopsy in the diagnosis of small fiber neuropathy. Report of a joint task force of the European Federation of Neurological Societies and the Peripheral Nerve Society. Eur J Neurol. 2010;17(7):903–12, e44–9. https://doi.org/10.1111/j.1468-1331.2010.03023.x. Lauria G, Hsieh ST, Johansson O, Kennedy WR, Leger JM, Mellgren SI, et al. European Federation of Neurological Societies/Peripheral Nerve Society Guideline on the use of skin biopsy in the diagnosis of small fiber neuropathy. Report of a joint task force of the European Federation of Neurological Societies and the Peripheral Nerve Society. Eur J Neurol. 2010;17(7):903–12, e44–9. https://​doi.​org/​10.​1111/​j.​1468-1331.​2010.​03023.​x.
29.
Zurück zum Zitat Peripheral Neuropathy Fact Sheet. In: NINDS, editor. NIH Publication No. 18-NS-48532018 August. Peripheral Neuropathy Fact Sheet. In: NINDS, editor. NIH Publication No. 18-NS-48532018 August.
48.
60.
64.
Zurück zum Zitat Slangen R, Schaper NC, Faber CG, Joosten EA, Dirksen CD, van Dongen RT, et al. Spinal cord stimulation and pain relief in painful diabetic peripheral neuropathy: a prospective two-center randomized controlled trial. Diabetes Care. 2014;37(11):3016–24. https://doi.org/10.2337/dc14-0684.CrossRefPubMed Slangen R, Schaper NC, Faber CG, Joosten EA, Dirksen CD, van Dongen RT, et al. Spinal cord stimulation and pain relief in painful diabetic peripheral neuropathy: a prospective two-center randomized controlled trial. Diabetes Care. 2014;37(11):3016–24. https://​doi.​org/​10.​2337/​dc14-0684.CrossRefPubMed
65.
Zurück zum Zitat van Beek M, Slangen R, Schaper NC, Faber CG, Joosten EA, Dirksen CD, et al. Sustained treatment effect of spinal cord stimulation in painful diabetic peripheral neuropathy: 24-month follow-up of a prospective two-center randomized controlled trial. Diabetes Care. 2015;38(9):e132-4. https://doi.org/10.2337/dc15-0740.CrossRefPubMed van Beek M, Slangen R, Schaper NC, Faber CG, Joosten EA, Dirksen CD, et al. Sustained treatment effect of spinal cord stimulation in painful diabetic peripheral neuropathy: 24-month follow-up of a prospective two-center randomized controlled trial. Diabetes Care. 2015;38(9):e132-4. https://​doi.​org/​10.​2337/​dc15-0740.CrossRefPubMed
67.
Zurück zum Zitat van Beek M, Geurts JW, Slangen R, Schaper NC, Faber CG, Joosten EA, et al. Severity of neuropathy is associated with long-term spinal cord stimulation outcome in painful diabetic peripheral neuropathy: five-year follow-up of a prospective two-center clinical trial. Diabetes Care. 2018;41(1):32–8. https://doi.org/10.2337/dc17-0983.CrossRefPubMed van Beek M, Geurts JW, Slangen R, Schaper NC, Faber CG, Joosten EA, et al. Severity of neuropathy is associated with long-term spinal cord stimulation outcome in painful diabetic peripheral neuropathy: five-year follow-up of a prospective two-center clinical trial. Diabetes Care. 2018;41(1):32–8. https://​doi.​org/​10.​2337/​dc17-0983.CrossRefPubMed
76.
Zurück zum Zitat Liao HY, Hsieh CL, Huang CP, Lin YW. Electroacupuncture attenuates CFA-induced inflammatory pain by suppressing Nav1.8 through S100B, TRPV1, opioid, and adenosine pathways in mice. Sci Rep. 2017;7:42531. https://doi.org/10.1038/srep42531. Liao HY, Hsieh CL, Huang CP, Lin YW. Electroacupuncture attenuates CFA-induced inflammatory pain by suppressing Nav1.8 through S100B, TRPV1, opioid, and adenosine pathways in mice. Sci Rep. 2017;7:42531. https://​doi.​org/​10.​1038/​srep42531.
90.
Zurück zum Zitat de Greef BTA, Hoeijmakers JGJ, Geerts M, Oakes M, Church TJE, Waxman SG, et al. Lacosamide in patients with Nav1.7 mutations-related small fibre neuropathy: a randomized controlled trial. Brain. 2019;142(2):263–75. https://doi.org/10.1093/brain/awy329. de Greef BTA, Hoeijmakers JGJ, Geerts M, Oakes M, Church TJE, Waxman SG, et al. Lacosamide in patients with Nav1.7 mutations-related small fibre neuropathy: a randomized controlled trial. Brain. 2019;142(2):263–75. https://​doi.​org/​10.​1093/​brain/​awy329.
92.
Zurück zum Zitat Labau JIR, Estacion M, Tanaka BS, de Greef BTA, Hoeijmakers JGJ, Geerts M, et al. Differential effect of lacosamide on Nav1.7 variants from responsive and non-responsive patients with small fibre neuropathy. Brain. 2020;143(3):771–82. https://doi.org/10.1093/brain/awaa016. Labau JIR, Estacion M, Tanaka BS, de Greef BTA, Hoeijmakers JGJ, Geerts M, et al. Differential effect of lacosamide on Nav1.7 variants from responsive and non-responsive patients with small fibre neuropathy. Brain. 2020;143(3):771–82. https://​doi.​org/​10.​1093/​brain/​awaa016.
97.
Zurück zum Zitat Maino P, Koetsier E, Kaelin-Lang A, Gobbi C, Perez R. Efficacious dorsal root ganglion stimulation for painful small fiber neuropathy: a case report. Pain Physician. 2017;20(3):E459–63.PubMed Maino P, Koetsier E, Kaelin-Lang A, Gobbi C, Perez R. Efficacious dorsal root ganglion stimulation for painful small fiber neuropathy: a case report. Pain Physician. 2017;20(3):E459–63.PubMed
Metadaten
Titel
Small Fiber Neuropathy
verfasst von
N. Strand
C. Wie
J. Peck
M. Maita
N. Singh
J. Dumbroff
V. Tieppo Francio
M. Murphy
K. Chang
D. M. Dickerson
J. Maloney
Publikationsdatum
06.04.2022
Verlag
Springer US
Erschienen in
Current Pain and Headache Reports / Ausgabe 6/2022
Print ISSN: 1531-3433
Elektronische ISSN: 1534-3081
DOI
https://doi.org/10.1007/s11916-022-01044-8

Weitere Artikel der Ausgabe 6/2022

Current Pain and Headache Reports 6/2022 Zur Ausgabe

Psychological and Behavioral Aspects of Headache and Pain (D Buse, Section Editor)

A Theoretical Endogenous Opioid Neurobiological Framework for Co-occurring Pain, Trauma, and Non-suicidal Self-injury

Childhood and Adolescent Headache (S Evers, Section Editor)

Emotional Problems in Pediatric Headache Patients

Acute Pain Medicine (R Urman, Section Editor)

Postdural Puncture Headache—Risks and Current Treatment

Anesthetic Techniques in Pain Management (D Wang, Section Editor)

Psychologic Impacts on Diabetic Neuropathic Pain

Acute Pain Medicine (R Urman, Section Editor)

Patients on Buprenorphine Formulations Undergoing Surgery

Childhood and Adolescent Headache (S Evers, Section Editor)

CGRP in Childhood and Adolescence Migraine: (Patho)physiological and Clinical Aspects

Ähnliche Überlebensraten nach Reanimation während des Transports bzw. vor Ort

29.05.2024 Reanimation im Kindesalter Nachrichten

Laut einer Studie aus den USA und Kanada scheint es bei der Reanimation von Kindern außerhalb einer Klinik keinen Unterschied für das Überleben zu machen, ob die Wiederbelebungsmaßnahmen während des Transports in die Klinik stattfinden oder vor Ort ausgeführt werden. Jedoch gibt es dabei einige Einschränkungen und eine wichtige Ausnahme.

Häusliche Gewalt in der orthopädischen Notaufnahme oft nicht erkannt

28.05.2024 Häusliche Gewalt Nachrichten

In der Notaufnahme wird die Chance, Opfer von häuslicher Gewalt zu identifizieren, von Orthopäden und Orthopädinnen offenbar zu wenig genutzt. Darauf deuten die Ergebnisse einer Fragebogenstudie an der Sahlgrenska-Universität in Schweden hin.

Fehlerkultur in der Medizin – Offenheit zählt!

28.05.2024 Fehlerkultur Podcast

Darüber reden und aus Fehlern lernen, sollte das Motto in der Medizin lauten. Und zwar nicht nur im Sinne der Patientensicherheit. Eine negative Fehlerkultur kann auch die Behandelnden ernsthaft krank machen, warnt Prof. Dr. Reinhard Strametz. Ein Plädoyer und ein Leitfaden für den offenen Umgang mit kritischen Ereignissen in Medizin und Pflege.

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

Update AINS

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.