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Acute steroid responsive small‐fiber sensory neuropathy: a new entity?
Author(s) -
Dabby Ron,
Gilad Ronit,
Sadeh Menachem,
Lampl Yair,
Watemberg Nathan
Publication year - 2006
Publication title -
journal of the peripheral nervous system
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1
H-Index - 67
eISSN - 1529-8027
pISSN - 1085-9489
DOI - 10.1111/j.1085-9489.2006.00062.x
Subject(s) - medicine , erythromelalgia , prednisone , peripheral neuropathy , skin biopsy , neuropathic pain , surgery , quantitative sensory testing , anesthesia , sensory system , dermatology , biopsy , endocrinology , neuroscience , diabetes mellitus , biology
Small‐fiber neuropathy is often idiopathic and commonly follows a chronic course. Treatment is often effective in treating the core symptom of pain, but it has no effect on the pathologic process. We describe four patients with acute small‐fiber neuropathy who responded dramatically to steroid therapy. All patients had acute onset neuropathic pain, normal nerve conduction studies, and evidence of small‐fiber dysfunction in quantitative sensory testing and skin biopsy. Symptoms were distal and symmetrical in three patients and generalized in one patient. In two cases, the neuropathy presented as an erythromelalgia‐like syndrome. Marked clinical improvement occurred 1–2 weeks after oral prednisone therapy was initiated. Three patients remained symptom free, and one patient experienced recurrence of neuropathy after prednisone was tapered.