Therapath Neuropathology

Small Fiber Neuropathy Symptoms

March 28, 2018

Haupt el al. conducted a long term review (2.5 to 14 years) of patients diagnosed with small fiber neuropathy (SFN) who did not have signs of large-fiber neuropathy.1 Patient symptoms included numbness, burning sensation, or reduced vibration sensitivity. Of the twelve patients reviewed, three were later diagnosed with large fiber neuropathy while nine remained stable.

“Patients suffering from SFN should be followed closely, treated symptomatically, and reassured that progression of their disease is unlikely.”1

Symptoms of small fiber neuropathy include numbness, burning pain, stabbing or aching pains, and sensations of pins and needles or electric shocks.2 Bakkers et al. examined a total of 265 patients diagnosed with small fiber neuropathy (SFN).3  They found that SFN was associated with a severe impairment in Quality of Life, with pain and autonomic symptoms explaining only a small portion of the findings.

Epidermal Nerve Fiber Density (ENFD) testing provides an objective diagnosis for small fiber neuropathy. Making the diagnosis of SFN provides an explanation for the symptoms, and helps direct further testing for potentially reversible causes, whose treatment can result in amelioration of the neuropathy.

Small Fiber Neuropathy Testing


Flossdorf P, Haupt W, Brunn A, et al. Long-Time Course of Idiopathic Small Fiber Neuropathy. Eur Neurol. 2018;79(3-4):161-165. [PubMed]
Tavee J, Zhou L. Small fiber neuropathy: A burning problem. Cleve Clin J Med. 2009;76(5):297-305. [PubMed]
Bakkers M, Faber C, Hoeijmakers J, Lauria G, Merkies I. Small fibers, large impact: quality of life in small-fiber neuropathy. Muscle Nerve. 2014;49(3):329-336. [PubMed]