Fiona Fischer, Maike F Dohrn, Romina Kapfenberger, Denver Igharo, Diana Seeber, Elena de Moya Rubio, Kalliopi Pitarokoili, Natalie Börsch, Martin Mücke, Roman Rolke, Jörg B Schulz, Andrea Maier
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引用次数: 0
Abstract
Background: Neuropathic pain is difficult to diagnose and treat. Small fiber neuropathy (SFN) flies under the radar of nerve conduction studies.
Objectives: The importance of a structured patient history and physical examination in the context of neuropathic pain is emphasized. Describing SFN as an important cause, the authors consider rare but partially treatable differential diagnoses. They conclude that autonomic symptoms are frequently associated, often presenting with diverse symptoms.
Methods: A selective literature research to present SFN symptoms as well as differential diagnostic and therapeutic steps in the context of SFN and rare diseases focusing on the autonomic nervous system.
Results: Neuropathic pain significantly reduces quality of life. To shorten the time until diagnosis and to initiate therapy, the authors recommend a structured patient history including sensory plus and minus symptoms and non-specific autonomic signs. If the initial search for the cause is not successful, rare causes such as treatable transthyretin (ATTR) amyloidosis and Fabry's disease or autoimmune causes should be considered, particularly in the case of progressive and/or autonomic symptoms.
Conclusion: The diagnosis and therapy of rare SFN requires interdisciplinary collaboration and, in many cases, a referral to specialized centers to achieve the best patient care.
期刊介绍:
Der Schmerz is an internationally recognized journal and addresses all scientists, practitioners and psychologists, dealing with the treatment of pain patients or working in pain research. The aim of the journal is to enhance the treatment of pain patients in the long run.
Review articles provide an overview on selected topics and offer the reader a summary of current findings from all fields of pain research, pain management and pain symptom management.
Freely submitted original papers allow the presentation of important clinical studies and serve the scientific exchange.
Case reports feature interesting cases and aim at optimizing diagnostic and therapeutic strategies.
Review articles under the rubric ''Continuing Medical Education'' present verified results of scientific research and their integration into daily practice.