Sommer Claudia, Üçeyler Nurcan
Fortschr Neurol Psychiatr. 2018 Aug;86(8):509-518. doi: 10.1055/a-0648-0450. Epub 2018 Aug 20.
Small fiber neuropathies (SFN) comprise a clinical syndrome typically associated with acral burning pain, where the pathophysiological processes affect the thinly myelinated A-delta and the unmyelinated C nerve fibers. Neurological examination thus reveals merely thermal sensory deficits. Nerve conduction studies in SFN are normal to marginally abnormal. To underpin suspicion of SFN, special psychophysical and neurophysiological examinations or a skin punch biopsy are needed. The search for the etiology of SFN is crucial and most frequently reveals diabetes mellitus or impaired glucose tolerance. Mutations in genes encoding voltage-gated sodium channels and other genetic alterations are being increasingly reported. Treatment depends on the underlying disease and follows the guidelines on the treatment of neuropathic pain.
小纤维神经病变（SFN）是一种临床综合征，通常与肢端灼痛相关，其病理生理过程影响薄髓鞘的Aδ神经纤维和无髓鞘的C神经纤维。因此，神经系统检查仅显示热感觉缺陷。SFN的神经传导研究结果正常或仅轻微异常。为了支持对SFN的怀疑，需要进行特殊的心理物理学和神经生理学检查或皮肤活检。寻找SFN的病因至关重要，最常见的病因是糖尿病或糖耐量受损。越来越多的报道称，编码电压门控钠通道的基因突变和其他基因改变与该病有关。治疗取决于潜在疾病，并遵循神经性疼痛的治疗指南。
