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Small Fiber Neuropathy in Patients Meeting Diagnostic Criteria for Fibromyalgia | OMICS International | Abstract
ISSN: 2329-6895

Journal of Neurological Disorders
Open Access

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Research Article

Small Fiber Neuropathy in Patients Meeting Diagnostic Criteria for Fibromyalgia

Todd D Levine1*, David S Saperstein1, Aidan Levine1, Kevin Hackshaw2 and Victoria Lawson2

1Phoenix Neurological Associates, 5090 N, 40th Street, Suite 250, Phoenix, AZ 85018, USA

2Division of Neuromuscular Diseases, Department of Neurology, The Ohio State Wexner Medical Center, 395 W. 12th Ave, 7th Floor, Columbus, OH 43210, USA

*Corresponding Author:
Todd D Levine
Phoenix Neurological Associates, LTD. 5090 N 40th
Street, Suite # 250, Phoenix, AZ 85018, USA
Tel: 6022583354
Fax: 6022583368
E-mail: [email protected]

Received date: September 21, 2016; Accepted date: October 06, 2016; Published date: October 11, 2016

Citation: Levine TD, Saperstein DS, Levine A, Hackshaw K, Lawson V (2016) Small Fiber Neuropathy in Patients Meeting Diagnostic Criteria for Fibromyalgia. J Neurol Disord 4:305. doi:10.4172/2329- 6895.1000305

Copyright: © 2016 Levine TD. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Introduction: The cause for fibromyalgia (FM) is unknown and diagnostic criteria can be nonspecific. Many patients with FM have nonspecific sensory symptoms consistent with a neuropathic process. Previous studies have shown that a significant percentage of patients diagnosed with FM have small fiber neuropathy (SFN) based on decreased intraepidermal nerve fiber density (IENFD) on according to punch skin biopsy testing. The purpose of this study was to demonstrate that punch skin biopsy testing is an effective way to identify SFN and its underlying causes in patients previously diagnosed with FM.

Methods: We studied 56 patients referred to peripheral nerve disease centers for evaluation of neuropathic pain who met the diagnostic criteria for FM. All underwent punch skin biopsy testing. If SFN was detected, patients underwent further laboratory testing to look for a potential cause for the neuropathy.

Results: Thirty-four of 56 patients (61%) had SFN, as indicated by reduced IENFD. Twenty-four of 34 patients with SFN (71%) had laboratory evidence that revealed an underlying etiology for the SFN.

Conclusions: More than half of the patients presenting with neuropathic pain and who met diagnostic criteria for FM had SFN detected by skin biopsy testing. A potential cause for neuropathy was identified in 71% of the patients with SFN. Skin biopsy testing to look for SFN is a very high-yield test in patients with FM who have neuropathic pain symptoms. Diagnosing SFN can facilitate the identification of potential causes for the neuropathy and alter their management.


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