to 20 million people in the United States over age 40 have some
type of peripheral neuropathy.In
many, the impairment is predominantly in small nerve fibers, and
the clinical presentation consists of pain, burning, tingling,
and numbness in a length-dependent or stocking-glove
neuropathy or small fiber neuropathy is caused by
damage to the smallest nerves that supply sensory
feelings, help regulate your heart rate, blood pressure,
perspiration and digestion, among other functions. Neuropathy
means damage to your nerves. Autonomic small fiber
neuropathy is are often due to diabetes, autoimmune
diseases, infections or toxic conditions. Your nerves transmit
messages between your brain and your organs. Damage to
your autonomic nerves results in faulty communication with your
brain and the affected parts of the body .Your nerves are
composed of many types of fibers and the smallest fiber is
affected by this neuropathy so it is called small fiber
neuropathy. The condition is fully and easily reversible.
Signs and symptoms are variable on which nerves are
affected but can range from dizziness to trouble with digestion and
urination to sexual difficulties. Treatment involves addressing the
underlying cause, if possible, and managing the signs and symptoms.
Signs and symptoms
Signs and symptoms of autonomic neuropathy depend on which parts
of your autonomic nervous system are most affected. They may
in blood pressure on standing (orthostatic hypotension),
which can cause dizziness and fainting
Trouble with urination, including diminished sensation,
overflow incontinence and inability to empty your bladder
completely, which can lead to urinary tract infections.
Male impotence or weak erectile function.
Numbness in toes very common and
may be the earliest and only symptom, feet or
genitals, abdomen. Tendency to trip easily. Burning
sensation on skin. Difficulty in judging accelerator
position while driving.
Trouble focusing eyes.
Vaginal dryness and difficulties with arousal and orgasm in
Difficulty digesting food (gastroparesis), which can cause
diarrhea, constipation, abdominal bloating, nausea,
vomiting, heartburn, feeling full after eating little and
loss of appetite
Cardiovascular problems, such as heart rate abnormalities
Heat intolerance, especially during exercise, and usually
decreased sweating or increase sweating.
Sluggish pupil reaction to light and dark
Exercise intolerance, which causes your heart rate to remain
unchanged instead of increasing and decreasing in response
to your activity level
Lack of the usual warning signs of low blood sugar
(hypoglycemia), which include shakiness, sweating and
Severe drop in blood pressure on standing: This is caused
when the heart rate fails to accelerate on standing up.
Signs to remember you may not get all of these signs
Urinary incontinenceUrinary tract infection
(UTI) Erectile dysfunction
Erectile dysfunction in diabetes: Keys to prevention
Vaginal dryness Diabetic gastroparesis
Cardiovascular disease 101: Know your heart and blood vessels
Numbness feeling in toes, fingers or abdomen. Burning and pain.
continue to next page of autonomic neuropathy