Therapath Neuropathology

Systematic review presents current understanding of Small Fiber Neuropathy

May 2, 2016

The review, published in the May 2016 issue of Muscle & Nerve, provides a comprehensive evaluation of Small Fiber Neuropathy (SFN) research.

Few systematic reviews have addressed the emerging topic of SFN over the last decade. In this review we present an up-to date understanding of SFN by addressing epidemiology,etiology, clinical presentation, diagnosis, pathophysiology, treatment, and outcome.

The authors compare several diagnostic methods for SFN and note that epidermal nerve fiber density (ENFD) through punch biopsy is sensitive, reliable, and efficient.1

In discussing etiology, the review highlights the importance of ENFD analysis for fibromyalgia patients.

Identifying SFN in fibromyalgia patients not only provides a specific diagnosis but also increases treatment options.

The review concludes that SFN patients require a “pragmatic workup…to optimize treatment”.1 The full article is available in Muscle & Nerve.


Chan A, Wilder-Smith E. Small fiber neuropathy: Getting bigger! Muscle Nerve. 2016;53(5):671-682. [PubMed]