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Small fiber neuropathy (SFN) is nowadays diagnosed more frequently in neuromuscular practice as a result of improved diagnostic techniques. Besides common etiologies, up to a third of cases are considered idiopathic. In recent years, several disorders have been unexpectedly reported in association with SFN, on clinical as well as complementary investigations, including Quantitative Sensory Testing, intraepidermal nerve fiber density and confocal corneal microscopy. Fibromyalgia, Parkinson Disease, rapid eye movement sleep behavior disorder, as well amyotrophic lateral sclerosis all have been described with unexpected high frequency in association with SFN. Other disorders including Ehlers Danlos syndrome have also been described concurrently with SFN, which has in addition been reported after vaccinations and alone or combined with large fiber involvement in the setting of inflammatory neuropathies including Guillain-Barré syndrome and chronic inflammatory demyelinating polyneuropathy. This article reviews these reported associations, their possible pathophysiologic basis as well as the potential resulting management implications.

 

Keywords: fiber neuropathy, Small fiber neuropathy

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