Neuropathy Digest Volume III. Selections include: Reduced nerve fiber density in patients with fibromyalgia, and mononeuropathy in complex regional pain syndrome (CRPS).

Oaklander and colleagues (ANA, 2012a) reported on their findings that a substantial number of patients with fibromyalgia have small fiber neuropathy. They measured the intraepidermal nerve fiber densities (IENF) in punch skin biopsies from patients with fibromyalgia and found that 50% had IENF densities below the 5th percentile of normal controls. The IENF density in fibromyalgia patients averaged 24 +/- 0.1% of predicted norm vs. 64 +/- 0.07 % in controls. Autonomic function testing and the Utah Early Neuropathy Scale also pointed to neuropathic changes in many of the fibromyalgia patients. The authors conclude that substantial numbers of fibromyalgia patients meet rigorous diagnostic criteria for small fiber neuropathy, possibly explaining their pain.