Prevalence of somatic small fiber neuropathy in elderly: a review

Abstract

Somatic small fiber neuropathy (SSFN) is a neuromuscular disease that affects peripheral nerves and leads to structural and functional changes involving small myelinated (Aδ) and unmyelinated (C) fibers, and whose pathophysiological mechanisms are not well elucidated, but depend on the underlying etiology. Due to the lack of studies on this pathology, it is likely to be underdiagnosed, which is a problem, since this disease in elderly people can lead to multiple negative effects on daily life due to neuropathic pain, paresthesia, and dysautonomia of various systems. The clinical diagnosis of this pathology is based on data from the clinical history and physical examination, as well as some complementary examinations and tests, such as the quantitative sudomotor axon reflex test (QSART). Moreover, the treatment of the disease is still limited and most approaches focus on the control of symptoms, such as neuropathic pain. The present study consists of a narrative review of the literature conducted in Medline databases from 2010 to 2022 on small-fiber neuropathy, the elderly, and neuralgia, using the terminology indicated by the Health Sciences Descriptor System (DeCS), and aims to highlight the relevance of the association of senile comorbidities and the aging process with somatic small-fiber neuropathy. Thus, future studies investigating the pathophysiological mechanisms of SSFN are of utmost importance, as well as studies aimed at developing more effective diagnostic methods.