Division of Pain Medicine, Mayo Clinic Hospital, Phoenix, AZ, USA.
Performing Arts Medicine Department, Shenandoah University, Winchester, USA.
Curr Pain Headache Rep. 2022 Jun;26(6):429-438. doi: 10.1007/s11916-022-01044-8. Epub 2022 Apr 6.
This narrative review aims to summarize advances in the field of small fiber neuropathy made over the last decade, with emphasis on novel research highlighting the distinctive features of SFN.
While the management of SFNs is ideally aimed at treating the underlying cause, most patients will require pain control via multiple, concurrent therapies. Herein, we highlight the most up-to-date information for diagnosis, medication management, interventional management, and novel therapies on the horizon. Despite the prevalence of small fiber neuropathies, there is no clear consensus on guidelines specific for the treatment of SFN. Despite the lack of specific guidelines for SFN treatment, the most recent general neuropathic pain guidelines are based on Cochrane studies and randomized controlled trials (RCTs) which have individually examined therapies used for the more commonly studied SFNs, such as painful diabetic neuropathy and HIV neuropathy. The recommendations from current guidelines are based on variables such as number needed to treat (NNT), safety, ease of use, and effect on quality of life.
本文旨在总结过去十年中小纤维神经病领域的进展，重点介绍突出 SFN 特征的新研究。
虽然 SFN 的治疗理想上旨在针对潜在病因，但大多数患者将需要通过多种同时进行的治疗来控制疼痛。在此，我们重点介绍最新的诊断、药物管理、介入管理和新疗法的信息。尽管小纤维神经病很常见，但针对 SFN 治疗的具体指南尚无明确共识。尽管 SFN 治疗缺乏具体指南，但最近的一般神经病理性疼痛指南是基于 Cochrane 研究和随机对照试验 (RCT)，这些研究分别检查了更常见研究的 SFNs（如痛性糖尿病神经病和 HIV 神经病）所使用的疗法。当前指南的建议基于一些变量，如需要治疗的人数（NNT）、安全性、易用性和对生活质量的影响。
