Small fiber neuropathy: Swiss cohort characterization

Lorena M Bitzi, Dirk Lehnick, Einar P Wilder-Smith, Lorena M Bitzi, Dirk Lehnick, Einar P Wilder-Smith

Abstract

Introduction/aim: There is currently insufficient clinical and epidemiological data concerning small fiber neuropathy (SFN). This research analyzes data from medical records to determine epidemiology, demographics, clinical characteristics and etiology of SFN.

Methods: This is a retrospective, observational study of sequential patients diagnosed with definite SFN (typical clinical features, normal nerve conduction studies, abnormal epidermal nerve fiber density) from the end of November 2016 to the middle of July 2019 at the Cantonal Hospital Lucerne, central Switzerland.

Results: A total of 84 patients (64.3% female) with a mean age of 54.7 y were analyzed. Symptoms had been present in patients for an average of 4.8 y when entering the study. A length dependent clinical pattern was seen in 79.8%. All patients had sensory discomfort. Etiology could not be determined in 35.7% of patients, who were diagnosed with idiopathic SFN; 34.5% of patients had an apparently autoimmune SFN, followed by14.3% of patients with metabolic causes. The estimated incidence was at least 4.4 cases/100.000 inhabitants/y. The minimum prevalence was 131.5 cases/100.000 inhabitants.

Discussion: This study indicates significant incidence and prevalence rates of SFN in Switzerland. SFN can vary greatly in its symptoms and severity. Extensive work-up resulted in two thirds of the patients being assigned an etiological association. The largest group of patients could not be etiologically defined, underlining the importance of further research on etiologic identification. We expect increased awareness of the developing field of SFN.

Keywords: autoimmune neuropathy; incidence prevalence; neuropathic pain; sensory and autonomic neuropathies; small fiber neuropathy.

Conflict of interest statement

None of the authors has any conflict of interest to disclose.

© 2021 The Authors. Muscle & Nerve published by Wiley Periodicals LLC.

Figures

FIGURE 1
FIGURE 1
Flowchart describing patient disposition
FIGURE 2
FIGURE 2
Comparison of the intensity of pain in the three groups. Average, average pain intensity in the past 4 wk; now, pain intensity when filling in the questionnaire; max, maximum pain intensity in the past 4 wk [Color figure can be viewed at wileyonlinelibrary.com]

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