Objective: To compare simple tests of small nerve fibre function, with intraepidermal nerve fibre density (IENFD) in the evaluation of small fibre neuropathy (SFN).
Methods: Patients with idiopathic SFN of the hands were prospectively studied. Evaluation involved clinical examination, nerve conduction studies, SSR, water and EMLA (eutectic mixture of local anesthetics) skin wrinkling.
Results: Of 21 patients, 16 (76.2%) had low IENFD, 15 (71.4%) impaired water-induced wrinkling, 14 (66.7%) impaired EMLA-induced wrinkling and 9 (42.9%) abnormal SSR.
Conclusions: Stimulated skin wrinkling was nearly as sensitive as IENFD in the diagnosis of SFN, SSR were of less use. Stimulated skin wrinkling is a useful supportive test where IENFD or other tests of small nerve fibre function are not available.
- Nerve Fibers, Unmyelinated
- Sensory and Autonomic neuropathies
- Skin Wrinkling
- Sympathetic Fibers, Postganglionic