Fortschr Neurol Psychiatr 2018; 86(08): 509-518
DOI: 10.1055/a-0648-0450
Fort- und Weiterbildung
© Georg Thieme Verlag KG Stuttgart · New York


Claudia Sommer
Nurcan Üçeyler
Further Information

Publication History

Publication Date:
20 August 2018 (online)

Das klinische Bild der Small-Fiber-Neuropathie, einer Erkrankung der dünn bemarkten A-delta- und unbemarkten C-Fasern, ist geprägt durch brennende akrale Schmerzen. Wichtig ist die Suche nach der Krankheitsursache, die vielfältig sein kann, am häufigsten jedoch Diabetes mellitus. Die klinische Verdachtsdiagnose wird untermauert durch spezielle Untersuchungen, die in diesem Beitrag ebenso wie die therapeutischen Möglichkeiten vorgestellt werden.

Small fiber neuropathies (SFN) comprise a clinical syndrome typically associated with acral burning pain, where the pathophysiological processes affect the thinly myelinated A-delta and the unmyelinated C nerve fibers. Neurological examination thus reveals merely thermal sensory deficits. Nerve conduction studies in SFN are normal to marginally abnormal. To underpin suspicion of SFN, special psychophysical and neurophysiological examinations or a skin punch biopsy are needed. The search for the etiology of SFN is crucial and most frequently reveals diabetes mellitus or impaired glucose tolerance. Mutations in genes encoding voltage-gated sodium channels and other genetic alterations are being increasingly reported. Treatment depends on the underlying disease and follows the guidelines on the treatment of neuropathic pain.

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