Small fiber sensory neuropathy (SFSN)

SFSN affects the small fibers of the peripheral nervous system, resulting in sensory disturbances which affect different areas of the body. The two types of SFSN are length-dependent SFSN, and non-length-dependent SFSN and these differ based on the location of the symptoms.

Burning pain or coldness, electric shock-like brief painful sensations, dry eyes, dry mouth, postural lightheadedness, presyncope, syncope, abnormal sweating, erectile dysfunction, nausea, vomiting, diarrhea, constipation, early satiety, and difficulty with urinary frequency. 

HIV, Guillain-Barré syndrome, chronic inflammatory demyelinating polyneuropathy, celiac disease, hepatitis, systemic lupus erythematosus, and Sjögren’s syndrome.

As opposed to length-dependent SFSN, non-length-dependent SFSN is more likely to affect females and has an earlier onset. The non-length-dependent form also has a higher association with immune-mediated conditions. Diabetes has also been identified as a common precursor to developing SFSN.

• Corneal confocal microscopy: A useful tool for diagnosis of small fiber neuropathy in type 2 diabetes (2021)
• Teaching neuroimage: Absence of wrinkles in small fiber neuropathy (2021)
• Small fiber neuropathy in sarcoidosis (2021)
• Small and large fiber sensory polyneuropathy in type 2 diabetes: Influence of diagnostic criteria on neuropathy subtypes (2020)