Abstract Details

Title Diagnostic Workup in Small Fiber Neuropathy: A Retrospective Review

Topic Clinical Neurophysiology

Presentation(s) P07 - (-)

Poster/Presentation
Number 185

Objective

Background BACKGROUND: Neuropathic pain from SFN is prevalent and is caused by a wide variety of disorders, many of which are treatable, especially if recognized early in the process.

Design/Methods DESIGN/METHODS: Between 2008-2012, we reviewed charts of patients meeting the inclusion criteria of distal parasthesias, normal Nerve conduction studies (normal Sural and Medial plantar nerves) & abnormal skin biopsy over at least one site of two distal site biopsied (foot and distal leg, 10 cm above lateral malleolus). All patients with SFN were also clinically screened for HSAN, Amyloidosis and Fabrys. Skin biopsy was interpreted by Therapth using standard definitions. The etiologic work up included, 2Hour GTT, B12, B1, B6, FANA, ESR, SPEP, HIV, HCV, CMP, TSH, Lipid Panel and CBC.

Results RESULTS: 32 females and 15 males (F:M=2:1) aged 28-65 years were studied. 5 patients were newly diagnosed Diabetic, 10 had impaired GTT. 5 patients gave history of moderate/heavy drinking for at least 5 years. Other abnormalities included abnormal FANA profile (>1:320) in 2 patients, Chronic HCV(1) and abnormal SPEP(1). 5 patients showed Positive Tilt table testing for POTS. The cause of neuropathy remained unknown in 23 patients.

Conclusions CONCLUSIONS: A systematic approach to the diagnosis of SFN is important because of the likelihood of finding an underlying treatable cause. Abnormal Glucose metabolism and alcohol (20/47) are the two most important causes of SFN.

Authors/Disclosures
Ruthanna Hunter, MD PRESENTER	No disclosure on file
Steven P. Sparagana, MD, FAAN	Dr. Sparagana has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Greenwich Biosciences. Dr. Sparagana has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Nobelpharma. The institution of Dr. Sparagana has received research support from Greenwich Biosciences. The institution of Dr. Sparagana has received research support from Tuberous Sclerosis Alliance. The institution of Dr. Sparagana has received research support from Novartis. Dr. Sparagana has a non-compensated relationship as a Professional Advisory Board Member, committee member with Tuberous Sclerosis Alliance that is relevant to AAN interests or activities.
Gulshan Uppal, MD, FAAN (Freeman Neurology and Headache Clinic)	Dr. Uppal has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Abbvie. Dr. Uppal has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Pfizer.
Miguel Chuquilin Arista, MD, FAAN	Dr. Chuquilin Arista has received personal compensation in the range of $500-$4,999 for serving as a Item writer with ��ɫ��. Dr. Chuquilin Arista has received personal compensation in the range of $500-$4,999 for serving as a Item Writer with ��ɫ��. Dr. Chuquilin Arista has received personal compensation in the range of $500-$4,999 for serving as a Item Writer with ��ɫ��. Dr. Chuquilin Arista has received personal compensation in the range of $500-$4,999 for serving as a Item reviewer with National Board of Medical Examiners. Dr. Chuquilin Arista has received personal compensation in the range of $500-$4,999 for serving as a Southeast regional advisory board with Argenx. Dr. Chuquilin Arista has received personal compensation in the range of $500-$4,999 for serving as a Focus group with Alexion. Dr. Chuquilin Arista has received personal compensation in the range of $0-$499 for serving as a Speaker with Periodic Paralysis Association.
Niranjan N. Singh, MD, FAAN	Dr. Singh has nothing to disclose.

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