Center for Autonomic and Peripheral Nerve Disorders, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02134, USA.
Curr Pain Headache Rep. 2011 Jun;15(3):193-200. doi: 10.1007/s11916-011-0181-7.
Small-fiber neuropathy manifests in a variety of different diseases and often results in symptoms of burning pain, shooting pain, allodynia, and hyperesthesia. Diagnosis of small-fiber neuropathy is determined primarily by the history and physical exam, but functional neurophysiologic testing and skin biopsy evaluation of intraepidermal nerve-fiber density can provide diagnostic confirmation. Management of small-fiber neuropathy depends on the underlying etiology with concurrent treatment of associated neuropathic pain. A variety of recent guidelines proposes the use of antidepressants, anticonvulsants, opioids, topical therapies, and nonpharmacologic treatments as part of the overall management of neuropathic pain. Unfortunately, little data about the treatment of pain specifically in small-fiber neuropathy exist because most studies combine mixed neuropathic pain syndromes in the analysis. Additional studies targeting the treatment of pain in small-fiber neuropathy are needed to guide decision making.
小纤维神经病在多种不同的疾病中表现出来，常导致灼热痛、刺痛、感觉过敏和感觉过度等症状。小纤维神经病的诊断主要取决于病史和体格检查，但功能神经生理学测试和表皮内神经纤维密度的皮肤活检评估可以提供诊断确认。小纤维神经病的治疗取决于潜在病因，并同时治疗相关的神经性疼痛。最近的多项指南建议将抗抑郁药、抗惊厥药、阿片类药物、局部治疗和非药物治疗作为神经病理性疼痛整体管理的一部分。不幸的是，由于大多数研究在分析中混合了混合神经性疼痛综合征，因此针对小纤维神经病疼痛治疗的数据很少。需要进一步的研究来针对小纤维神经病的疼痛治疗，以指导决策。
