Multifocal Small Fiber Sensory Neuropathy

Abstract

: To report four patients with unusual multifocal patterns of small fiber sensory neuropathy : Four patients who developed multifocal sensory symptoms after infectious illnesses underwent neurologic examinations, nerve conduction studies, and serologic testing. All had one to three types of electrodiagnostic assessments of small nerve fibers by evaluation of thermal and vibratory thresholds. quantitative sudomotor axon reflex testing, or autonomic cardiovascular testing. Nerve conduction and serologic studies were normal. Quantitative sudomotor axon reflex testing, autonomic cardiovascular testing, or both revealed abnormalities of small fiber function in all patients, and thermal thresholds were abnormal in one. Three had progression and fluctuations of symptoms for months. : Small fiber sensory neuropathies occasionally occur in a multifocal rather than the typical distal distribution and may comprise part of the spectrum of postinfectious sensory neuropathies. Objective testing of small fiber function is useful in distinguishing small fiber sensory neuropathy from other causes of paresthesias in this setting.