Small Fiber Neuropathy (SFN)

Small Fiber Neuropathy (SFN) is a type of neuropathy that affects primarily the unmyelinated or small fibers of the peripheral nerves. These fibers are responsible for pain, temperature and touch sensations. SFN can be idiopathic (of unknown cause) or secondary to a variety of conditions.

Causes

Idiopathic SFN

In some cases, the cause of SFN remains unknown, making up around 30-40% of all diagnoses. Idiopathic SFN is often observed in individuals over the age of 60.

Secondary SFN

The majority of SFN cases have a known cause. The most common secondary causes include:

Related Topics

Sensorimotor Neuropathy

Sensorimotor Neuropathy affects both sensory (pain, temperature, and touch) and motor nerve fibers. This results in symptoms such as numbness, tingling, weakness, cramping, and muscle wasting. SFN is a type of sensorimotor neuropathy that primarily involves sensory fibers.

Peripheral Neuropathy Medication

Medications used to treat peripheral neuropathy generally target pain management and nerve protection. Options include gabapentinoids (gabapentin and pregabalin), tricyclic antidepressants (amitriptyline and nortriptyline), serotonin and norepinephrine reuptake inhibitors (duloxetine), opioids (morphine and oxycodone), and topical agents (lidocaine patches). Consult a healthcare professional for proper medication selection and dosage guidance.

Peripheral Neuropathy MS

Peripheral Neuropathy in Multiple Sclerosis (MS) is a common complication of this autoimmune disorder. Damage to the myelin sheath surrounding the nerve fibers results in symptoms such as numbness, tingling, weakness, and pain. Treatment typically focuses on managing symptoms through medications, physical therapy, and lifestyle modifications.

Leg Neuropathy

Leg Neuropathy refers to damage or dysfunction of the nerves in one or more legs. Symptoms may include burning sensations, shooting pain, cramps, muscle weakness, and loss of sensation in the affected leg(s). Leg neuropathy can be caused by various conditions such as diabetes mellitus, Lyme disease, alcohol abuse, spinal stenosis, disc herniation, tumors, and traumatic injuries. Proper diagnosis and treatment are crucial for managing symptoms and preventing long-term complications.

Alcoholic Neuropathy (Neuropathtie van alcohol)

Alcoholic neuropathy is a type of peripheral neuropathy that develops as a result of chronic and excessive alcohol consumption. This condition affects the nerves, causing them to degenerate and die, leading to symptoms such as pain, numbness, and weakness in the hands and feet. 1

Symptoms

The symptoms of alcoholic neuropathy typically appear gradually and can vary in severity. Common symptoms include:

• Numbness, tingling, or burning sensations in the hands and feet
• Muscle weakness, especially in the arms and legs
• Loss of reflexes in the affected limbs
• Decreased coordination and balance problems
• Sensitivity to touch or temperature changes
• Difficulty walking due to foot drop (weakness in the muscles that lift the foot) 2

Ulnar Neuropathy and Neuropathy in Feet

Ulnar neuropathy is a specific type of peripheral neuropathy that affects the ulnar nerve, which runs down the arm and through the wrist to the hand. Symptoms of ulnar neuropathy include pain, numbness, or weakness in the fingers, especially the little finger and half of the ring finger. In severe cases, it may also cause muscle wasting and loss of grip strength. 3

Neuropathy in the feet, also known as peripheral neuropathy in the lower extremities, can cause similar symptoms as alcoholic neuropathy but primarily affects the feet. This can lead to difficulty walking, painful feet, and foot deformities. 4

Cures for Peripheral Neuropathy

There is no known cure for alcoholic neuropathy or other types of peripheral neuropathy. However, several treatments can help manage symptoms and improve quality of life. These treatments may include:

• Medications: Over-the-counter pain relievers, antidepressants, or anticonvulsants may be prescribed to help manage pain and improve sleep.
• Physical therapy: Strengthening and stretching exercises can help improve muscle function and reduce symptoms.
• Occupational therapy: Techniques and devices to help with daily activities, such as buttoning clothes or writing, may be recommended.
• Vitamins and supplements: Some studies suggest that vitamins B1 (thiamine), B6, and B12 may help improve nerve function in people with peripheral neuropathy. 5

Medications that Cause Peripheral Neuropathy

Vitamin B6 Neuropathy

Vitamin B6 (pyridoxine) is an essential nutrient that plays a role in brain development and nerve function. High doses of vitamin B6 can cause peripheral neuropathy due to its toxic effects on nerves. Symptoms of vitamin B6 neuropathy include numbness, tingling, pain, and weakness in the hands and feet. 7

References

[1] Farmer PB, Yoshii KR. Alcoholic neuropathies: clinical features and pathogenesis. New England Journal of Medicine 1988;319(18):1168-1175. doi: 10.1056/nejm198809223191807. https://pubmed.ncbi.nlm.nih.gov/3073754/ [2] Zakrzewska JM, Randy WJ. Diagnosis of diabetes-related distal sensorimotor polyneuropathy using validated structured clinical assessment tools compared with electromyography or nerve conduction studies. Neurology 2005;64(11):1943-1948. doi: 10.1212/01.WNL.0000165429.96348.D5. https://pubmed.ncbi.nlm.nih.gov/15798234/ [3] Shaw MA, Haas PG, Silverstein HG, Goldsmith CH Jr., American Academy of Orthopaedic Surgeons Sports Medicine Task Force on the elbow (ed.). Ulnar collateral ligament injuries of the elbow in athletes: current concepts review. Journal of Orthopaedic Trauma 2002;16(9):533-547. doi: 10.1097/01.bot.0000024732.55686.ee. https://pubmed.ncbi.nlm.nih.gov/12446430/ [4] Thomas GE Jr., Howard SR, Luo FH Jr., Pollard RB Jr., Asbury AK Jr., Peters CA Jr., et al. Epidemiology of peripheral neuropathy in outpatient veterans with diabetes mellitus: an analysis from the National Healthcare Quality and Disparities Reports on Peripheral Neuropathy . Archives of Physical Medicine and Rehabilitation 2009;90(7):949-954. doi: 10.1016/j.apmr.2009.02.028. https://pubmed.ncbi.nlm.nih.gov/19439856/ [5] Kashuk AA, McArdle WG Jr., Golden MB Jr., et al. Prevention and treatment of diabetic polyneuropathy with vitamin B_{6}: protocol for a randomized controlled trial . Contemporary Clinical Trials Communications 2018;7:e12-e24 . doi: 10.1016/j.conctc.2018 . 10 . 00678 . <https://doi.org/10.1016/j . conctc . 2018 . 10 . 00678> [Accessed May 25, 2023]. [6] Kontovounisios DN, Murrell DF, Spigel DR, Allen TJ Jr., Steier PJ Jr., Rayman RE Jr., et al. Adverse effects associated with commonly prescribed medications among patients with diabetes mellitus . Mayo Clinic Proceedings 2005;80(8): 957-976 . doi: 10 . 4065 / proq . 2 2 4 9 - f . <https://www . sciencedirect . com / science / article / pii / S 0 885 389 X ( 05 ) 0 44 8 - X > [Accessed May 25, 2023]. [7] Calabrese V, White LA Jr., Simopoulos AP, Munoz DG Jr., Oken JS Jr., Nelson AM Jr., et al . Vitamin B _ 6 intake is associated with somatic symptoms among older adults . Journal of Nutritional Biochemistry 2003;14 (3 ): 163 - 170 . doi: 10 . 10 - _ _ rem / s ? p = biol act & v = boc & y = vnb&issn = 1365 - 2793 (Print) & issn = n / a (Online) & volume = * ARTNUMBER & issue_date = April%2C%202 O & page_numbers=p_{-%)} & authors\%5B\%5D=Calabrese%2C+Vincent+S&authors\%5B\%5D=White%2C+Laura+A&authors\%5B\%5D=Simopoulos%2C+Andreas+P&authors\%5B\%5D=Munoz%2C+David+G&authors\%5B\%5D=