Publication details

Aetiology of small- and mixed-fiber neuropathy

Authors

VLČKOVÁ Eva BEDNAŘÍK Josef DUŠEK Ladislav TOYKA K. SOMMER K.

Year of publication 2006
Type Conference abstract
MU Faculty or unit

Faculty of Medicine

Citation
Description Aim Small-fiber neuropathy (SFN) is reported to be associated with a range of diseases or conditions that are partly different from those associated with large-fiber affection. The aim of the study is to evaluate aetiology in a group of SFN patients in comparison with mixed (i.e., small- and large-) fiber neuropathy (MFN). Methods A detailed medical history was taken and exhaustive blood tests, chest radiography and lumbar puncture were performed in a group of 84 patients with “burning feet” syndrome and clearly proven affection of small nerve fibers (verified by abnormal thermal thresholds and reduced intra-epidermal nerve fiber density in the distal calf). Thirty-three of them also exhibited nerve conduction abnormalities as a sign of large-fibre involvement (MFN group). Results The range and proportions of causes were similar in SFN and MFN subgroups. Diabetes mellitus and chronic alcohol abuse were the most prominent aetiologies (33%; 15%), while further causes were less common and included monoclonal gammopathy, amyloidosis, toxic aetiology, paraneoplastic mechanism, systemic rheumatic diseases, neuroborreliosis, B12 deficiency and critical illness. Hypertriglyceridaemia was demonstrated in more than a third of the patients, but was only mild in most cases. No clear aetiology was found in about 30% of the cases in either subgroup. Conclusions Small-fiber neuropathy is probably not an independent entity, at least from an aetiological point of view. The main causes of both small- and mixed-fiber polyneuropathies in developed countries are diabetes mellitus and chronic alcohol abuse. About one-third of cases remained idiopathic.
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