Small fiber neuropathies may occur as a result of common (diabetes mellitus) and uncommon (genetic enzyme deficiency) causes. Sometimes, a cause for small fiber neuropathy cannot be established within the limits of modern medicine.
Small fiber neuropathies are painful and can be difficult to diagnose because other causes of pain are usually considered first and traditional tests (such as EMG/NCS) are normal. However, with a thorough neurological history and exam patients appropriate for testing can be identified.
The small 1 centimeter skin samples are taken from the thigh and foot near the ankle in the office, and then sent to a laboratory for analysis of small nerve fiber density in the skin. A small amount of local anesthesia is used under the skin to keep the procedure pain free.
