Small fiber neuropathy
Overview by M.C.& modification by I.K. USA
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 distribution.
Autonomic 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
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 of autonomic neuropathy depend on which parts
of your autonomic nervous system are most affected. They may
Severe drop in blood pressure on standing: This is caused when
the heart rate fails to accelerate on standing up.
- A drop in blood pressure on standing
(orthostatic hypotension), which can cause dizziness and
- Trouble with urination, including
diminished sensation, overflow incontinence and inability to
empty your bladder completely, which can lead to urinary tract
- Male impotence or weak erectile
- 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 women
- 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
- Heat intolerance, especially during
exercise, and usually decreased sweating or increase sweating.
- Sluggish pupil reaction to light and
- 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
Signs to remember you may not get all of these signs.
- Urinary incontinence
- Urinary tract infection (UTI)
- Erectile dysfunction
- Erectile dysfunction in diabetes: Keys to prevention
- Vaginal dryness
- Diabetic gastroparesis
- Cardiovascular disease 101: Know your heart and blood
- Numbness feeling in toes, fingers or abdomen. Burning
Your nervous system is made up of two parts. The core is your
central nervous system — your brain and spinal cord. The rest of
your nervous system, branching off from your spinal cord to the
rest of your body, is your peripheral nervous system.
Part of the peripheral nervous system involves nerves that
you consciously control — such as nerves you use to move your
voluntary muscles. Part is your autonomous nervous system — the
nerves that regulate the part of your nervous system that you
can't control, such as your heart rate, blood pressure and
Damage to your peripheral nerves is called peripheral
neuropathy. Autonomic neuropathy is a type of peripheral
neuropathy in which the very small nerves are damaged.
A number of conditions can lead to damage of the autonomic
nerves. The most common cause is diabetes. About half of the
people who have diabetes eventually develop some type of
Other causes may include:
- Alcoholism, a chronic,
progressive disease that can lead to nerve damage
- Poor diet White rice, white flour,
white sugar no fatty acids in diet.
- Infection from virus, mycoplasma
- Abnormal protein buildup in organs (amyloidosis),
which affects the organs and the nervous system
in which your immune system attacks and damages parts of
your body, including your nerves
- Some tumors, which can press on
nerves and cause direct or remote damage (paraneoplastic
- Multiple system atrophy, a
degenerative disorder that destroys the nervous system
- Surgical or traumatic injury
to nerves, injury can be from a car accident.
- Other chronic illnesses such as
Parkinson's disease and HIV/AIDS
disease more info
Having diabetes puts you at high risk of developing nerve damage,
including autonomic neuropathy. The longer you have diabetes, the
higher your risk. Risk is highest for people who've had the disease
for more than 25 years, who are older than 40 and who have
difficulty controlling their blood sugar.
Researchers currently think diabetes is a autoimmune disorder. In
fact, the higher the blood sugar, the greater chance you have of
nerve damage. Controlling blood sugar — keeping it as close to the
normal range as possible — decreases the risk of developing nerve
damage or helps keep it from progressing.
When to seek medical advice
If you have diabetes, a compromised immune system or other
chronic medical condition, see your doctor regularly. Seek medical
care promptly if you begin experiencing any of the signs and
symptoms of autonomic neuropathy. If your doctor does not prescribe
IVIg or tells you there is no treatment please contact us, we can
help you even if your insurance denies IVIg.