A 58-year-old woman with clinically probable small fiber neuropathy (SFN)11. Cazzato D, Lauria G. Small fibre neuropathy. Curr Opin Neurol. 2017 Oct;30(5):490-9. https://doi.org/10.1097/WCO.0000000000000472
https://doi.org/https://doi.org/10.1097/...
, with normal electroneuromyography, was evaluated with pain-related nociceptive evoked potential (PREP) with a concentric planar electrode stimulation on the dorsum of the hands and feet22. Hernandez Fustes OJ, Kay CSK, Lorenzoni PJ, Ducci RDP, Werneck LC, Scola RH. Somatosensory evoked potentials in clinical practice: a review. Arq Neuro-Psiquiatr. 2021 Sep;79(9):824-31. https://doi.org/10.1590/0004-282X-ANP-2020-0427
https://doi.org/https://doi.org/10.1590/...
and skin wrinkle test (SWT)33. O’Riain S. New and simple test of nerve function in hand. Br Med J. 1973 Sep;3(5881):615-6. https://doi.org/1010.1136/bmj.3.5881.615
https://doi.org/https://doi.org/1010.113...
. The PREP showed N1 latency delay (Figure 1), compatible with the change in SWT induced by water, which indicated a Grade 0 pattern (Figure 2), as can be seen in sympathetic autonomic small fiber dysfunction.
New electrophysiological tools, combined with SWT and specific neurological examination, contribute to the diagnosis of SFN.
Multiple-choice questions with related answers are given in Supplementary Material. The following material is available online for this article: https://www.arquivosdeneuropsiquiatria.org/wp-content/uploads/2022/02/ANP_2021327_material-suplementar_16-02.pdf
References
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1Cazzato D, Lauria G. Small fibre neuropathy. Curr Opin Neurol. 2017 Oct;30(5):490-9. https://doi.org/10.1097/WCO.0000000000000472
» https://doi.org/https://doi.org/10.1097/WCO.0000000000000472 -
2Hernandez Fustes OJ, Kay CSK, Lorenzoni PJ, Ducci RDP, Werneck LC, Scola RH. Somatosensory evoked potentials in clinical practice: a review. Arq Neuro-Psiquiatr. 2021 Sep;79(9):824-31. https://doi.org/10.1590/0004-282X-ANP-2020-0427
» https://doi.org/https://doi.org/10.1590/0004-282X-ANP-2020-0427 -
3O’Riain S. New and simple test of nerve function in hand. Br Med J. 1973 Sep;3(5881):615-6. https://doi.org/1010.1136/bmj.3.5881.615
» https://doi.org/https://doi.org/1010.1136/bmj.3.5881.615
Publication Dates
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Publication in this collection
20 Apr 2022 -
Date of issue
May 2022
History
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Received
11 Aug 2021 -
Reviewed
18 Oct 2021 -
Accepted
27 Oct 2021