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The Clinical Features of Painful Small‐Fiber Neuropathy Suggesting an Origin Linked to Primary Sjögren's Syndrome
Author(s) -
Zouari Hela G.,
Wahab Abir,
Ng Wing Tin Sophie,
Sène Damien,
Lefaucheur JeanPascal
Publication year - 2019
Publication title -
pain practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 58
eISSN - 1533-2500
pISSN - 1530-7085
DOI - 10.1111/papr.12763
Subject(s) - sudomotor , medicine , sensation , anxiety , psychology , neuroscience , psychiatry
Objective We attempted to determine whether clinical features could differentiate painful small‐fiber neuropathy related to primary Sj€ogren's syndrome ( pSS ‐ SFN ) from idiopathic SFN (idio‐ SFN ). Methods Validated clinical questionnaires and neurophysiological investigations specific for pain and SFN assessment were performed in 25 patients with pSS ‐ SFN and 25 patients with idio‐ SFN . Results Patients with idio‐ SFN had more frequent severe burning sensations and higher mean anxiety scores and daily pain intensity compared to patients with pSSSFN . Conversely, patients with pSS ‐ SFN had reduced electrochemical skin conductance measured by Sudoscan_, and almost half of them had the sensation of walking on cotton wool. Conclusion Our results suggest that idio‐ SFN more specifically involved small sensory fibers than pSS ‐ SFN , in which subtle dysfunction of larger sensory fibers and damage of distal autonomic sudomotor innervation may occur. A practical algorithm is proposed to help to differentiate SFN associated with pSS from idio‐ SFN , based on information very easy to obtain by clinical interview.