Advances in the Management of Small Fiber Neuropathy

The field of SFN is has had exciting developments in recent years, and shows promise for future burgeoning findings regarding diagnostics and management to improve symptoms and quality of life in this patient population. Improved autonomic and pathologic diagnostics have allowed discovery of SFN in a much more definitive fashion. More and more cases of so-called fibromyalgia or nonspecific cramps and even CRPS are now being diagnosed as SFN. And etiologic investigation and treatment have been more elucidated by advances in knowledge about sodium channelopathy neuropathies, familial TTR amyloid neuropathy, and novel biomarkers for immunemediated SFN such as TS-HDS, FGFR-3, and Plexin D1. Clinical trials for therapies in these novel etiologies, with objective endpoints and using the new biomarkers, will hopefully continue to emerge, such as IVIg for inflammatory SFN.