Small Fiber Neuropathy

Small fiber neuropathy involves selective damage to small myelinated and unmyelinated peripheral nerve fibers. Clinical features include pain, burning, and dysautonomia. Etiologies include diabetes, autoimmune disease, toxins, and idiopathic forms. Pathophysiology involves axonal degeneration of small fibers, leading to sensory and autonomic dysfunction. Diagnosis relies on clinical evaluation, skin biopsy, and autonomic testing. Management includes symptom control, treatment of underlying cause, and neuropathic pain management; prognosis is variable depending on etiology.