N Strand1, C Wie2, J Peck3, M Maita2, N Singh4, J Dumbroff5, V Tieppo Francio6, M Murphy6, K Chang7, D M Dickerson8,9, J Maloney2. 1. Division of Pain Medicine, Mayo Clinic Hospital, Phoenix, AZ, USA. strand.natalie@mayo.edu. 2. Division of Pain Medicine, Mayo Clinic Hospital, Phoenix, AZ, USA. 3. Performing Arts Medicine Department, Shenandoah University, Winchester, USA. 4. OrthoAlabama Spine and Sports, Birmingham, AL, USA. 5. Mount Sinai Morningside and West Department of Anesthesiology, New York, NY, USA. 6. Department of Rehabilitation on Medicine, The University of Kansas Medical Center, Kansas City, KS, USA. 7. Department of Anesthesiology and Critical Care, Emory University, Atlanta, GA, USA. 8. NorthShore University HealthSystem, Evanston, IL, USA. 9. University of Chicago Medicine, Chicago,, IL, USA.
Abstract
PURPOSE OF REVIEW: This narrative review aims to summarize advances in the field of small fiber neuropathy made over the last decade, with emphasis on novel research highlighting the distinctive features of SFN. RECENT FINDINGS: While the management of SFNs is ideally aimed at treating the underlying cause, most patients will require pain control via multiple, concurrent therapies. Herein, we highlight the most up-to-date information for diagnosis, medication management, interventional management, and novel therapies on the horizon. Despite the prevalence of small fiber neuropathies, there is no clear consensus on guidelines specific for the treatment of SFN. Despite the lack of specific guidelines for SFN treatment, the most recent general neuropathic pain guidelines are based on Cochrane studies and randomized controlled trials (RCTs) which have individually examined therapies used for the more commonly studied SFNs, such as painful diabetic neuropathy and HIV neuropathy. The recommendations from current guidelines are based on variables such as number needed to treat (NNT), safety, ease of use, and effect on quality of life.
PURPOSE OF REVIEW: This narrative review aims to summarize advances in the field of small fiber neuropathy made over the last decade, with emphasis on novel research highlighting the distinctive features of SFN. RECENT FINDINGS: While the management of SFNs is ideally aimed at treating the underlying cause, most patients will require pain control via multiple, concurrent therapies. Herein, we highlight the most up-to-date information for diagnosis, medication management, interventional management, and novel therapies on the horizon. Despite the prevalence of small fiber neuropathies, there is no clear consensus on guidelines specific for the treatment of SFN. Despite the lack of specific guidelines for SFN treatment, the most recent general neuropathic pain guidelines are based on Cochrane studies and randomized controlled trials (RCTs) which have individually examined therapies used for the more commonly studied SFNs, such as painful diabetic neuropathy and HIV neuropathy. The recommendations from current guidelines are based on variables such as number needed to treat (NNT), safety, ease of use, and effect on quality of life.
Authors: Mohammad A Khoshnoodi; Shaun Truelove; Ahmet Burakgazi; Ahmet Hoke; Andrew L Mammen; Michael Polydefkis Journal: JAMA Neurol Date: 2016-06-01 Impact factor: 18.302
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