Management is focused on the treatment of the underlying cause and analgesia, as there is no neuroprotective therapy. New diagnostic techniques, in particular measurement of intraepidermal nerve fibre density, have significantly improved the diagnostic efficiency of SFN. The diagnosis of SFN is demanding as clinical features can be vague and nerve conduction studies normal. SFN complicates a number of common diseases such as diabetes mellitus and is likely to be increasingly encountered. The clinical presentation is dominated by pain. Small fibre neuropathy (SFN) is characterised by structural injury selectively affecting small diameter sensory and/or autonomic axons.
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