Suzuki Chieko
Department of Neurology, Hirosaki University Graduate School of Medicine and School of Medicine.
Brain Nerve. 2022 May;74(5):614-620. doi: 10.11477/mf.1416202088.
Small-fiber neuropathies are a heterogeneous group of disorders affecting thinly myelinated Aδ and unmyelinated C fibers. Patients generally present with neuropathic pain, while dysesthesia, allodynia, pain, burning sensations, and cold sensations are frequently present in a length-dependent pattern. Additional autonomic features of the gastrointestinal, urinary, or cardiovascular systems are frequently observed. Deep-tendon reflexes and nerve conduction tests yield normal results. Skin biopsy is useful for the diagnosis, and can demonstrate the loss of intraepidermal nerve fibers in small-fiber neuropathy and has a diagnostic sensitivity of 80%. Although many causes of small-fiber neuropathy have been reported, the cause remains unknown in 30-50% of the cases. Treatment is directed at the underlying etiology and is supported with symptomatic treatment.
小纤维神经病变是一组异质性疾病，累及薄髓鞘Aδ纤维和无髓鞘C纤维。患者通常表现为神经性疼痛，而感觉异常、痛觉过敏、疼痛、烧灼感和冷感常呈长度依赖性分布。胃肠道、泌尿系统或心血管系统的自主神经功能障碍也较为常见。深部腱反射和神经传导测试结果通常正常。皮肤活检对诊断有帮助，可显示小纤维神经病变中表皮内神经纤维的缺失，诊断敏感性为80%。尽管已报道了许多小纤维神经病变的病因，但30%-50%的病例病因仍不明。治疗针对潜在病因，并辅以对症治疗。
