Definition and diagnosis of small fiber neuropathy: consensus from the Peripheral Neuropathy Scientific Department of the Brazilian Academy of Neurology

Francisco de Assis Aquino Gondim; Amilton Antunes Barreira; Rinaldo Claudino; Márcia Waddington Cruz; Francisco Marcos Bezerra da Cunha; Marcos Raimundo Gomes de Freitas; Marcondes Cavalcante França Jr; Marcus Vinícius Magno Gonçalves; Wilson Marques Jr; Osvaldo José Moreira Nascimento; Acary Souza Bulle Oliveira; Raquel Campos Pereira; Camila Pupe; Francisco Tellechea Rotta; Pedro Schestatsky

doi:10.1590/0004-282X20180015

Arquivos de Neuro-Psiquiatria, Table of Contents

CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2018; 76(03): 200-208
DOI: 10.1590/0004-282X20180015

Brazilian Academy of Neurology

Definition and diagnosis of small fiber neuropathy: consensus from the Peripheral Neuropathy Scientific Department of the Brazilian Academy of Neurology

Definição e diagnóstico de neuropatia de fibras finas: consenso do Departamento Científico de Neuropatias Periféricas da Academia Brasileira de Neurologia.

Francisco de Assis Aquino Gondim

¹Universidade Federal do Ceará, Faculdade de Medicina, Hospital Universitário Walter Cantídio, Fortaleza CE, Brasil

,

Amilton Antunes Barreira

²Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Neurociências e Hospital das Clínicas, Ribeirão Preto SP, Brasil

,

Rinaldo Claudino

³Universidade Federal de Santa Catarina, Florianópolis, SC, Brasil

,

Márcia Waddington Cruz

⁴Universidade Federal do Rio de Janeiro, Departamento de Neurologia, Rio de Janeiro RJ, Brasil

,

Francisco Marcos Bezerra da Cunha

⁵Universidade Federal do Cariri, Barbalha CE, Brasil

,

Marcos Raimundo Gomes de Freitas

⁶Universidade Federal Fluminense, Faculdade de Medicina, Departamento de Neurologia, Niterói RJ, Brasil

,

Marcondes Cavalcante França Jr

⁷Universidade de Campinas, Departamento de Neurologia, Campinas SP, Brasil

,

Marcus Vinícius Magno Gonçalves

⁸Universidade da Região de Joinville, Joinville SC, Brasil

,

Wilson Marques Jr

²Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Neurociências e Hospital das Clínicas, Ribeirão Preto SP, Brasil

,

Osvaldo José Moreira Nascimento

⁶Universidade Federal Fluminense, Faculdade de Medicina, Departamento de Neurologia, Niterói RJ, Brasil

,

Acary Souza Bulle Oliveira

⁹Universidade Federal de São Paulo, Departamento de Neurologia, São Paulo SP, Brasil

,

Raquel Campos Pereira

¹⁰Universidade Federal de Uberlândia, Faculdade de Medicina, Uberlândia MG, Brasil

,

Camila Pupe

⁶Universidade Federal Fluminense, Faculdade de Medicina, Departamento de Neurologia, Niterói RJ, Brasil

,

Francisco Tellechea Rotta

¹¹Hospital Moinhos de Vento, Porto Alegre RS, Brasil

,

Pedro Schestatsky

¹¹Hospital Moinhos de Vento, Porto Alegre RS, Brasil

› Author Affiliations

Abstract

ABSTRACT

The aim of this study was to describe the results of a Brazilian Consensus on Small Fiber Neuropathy (SFN). Fifteen neurologists (members of the Brazilian Academy of Neurology) reviewed a preliminary draft. Eleven panelists got together in the city of Fortaleza to discuss and finish the text for the manuscript submission. Small fiber neuropathy can be defined as a subtype of neuropathy characterized by selective involvement of unmyelinated or thinly myelinated sensory fibers. Its clinical picture includes both negative and positive manifestations: sensory (pain/dysesthesias/pruritus) or combined sensory and autonomic complaints, associated with an almost entirely normal neurological examination. Standard electromyography is normal. A growing list of medical conditions is associated with SFN. The classification of SFN may also serve as a useful terminology to uncover minor discrepancies in the normal values from different neurophysiology laboratories. Several techniques may disclose sensory and/or autonomic impairment. Further studies are necessary to refine these techniques and develop specific therapies.

RESUMO

O objetivo deste estudo é descrever os resultados de um Consenso Brasileiro sobre Neuropatia de Fibras Finas (NFF). Quinze neurologistas (membros da Academia Brasileira de Neurologia) revisaram uma versão preliminar do artigo. Onze panelistas se reuniram na cidade de Fortaleza para discutir e terminar o texto para a submissão do manuscrito. NFF pode ser definida como um subtipo de neuropatia caracterizada pelo envolvimento seletivo de fibras sensitivas amielínicas ou pouco mielinizadas. Seu quadro clínico inclui manifestações negativas e positivas: sensitivas (dor/disestesias/prurido) ou queixas sensitivas e autonçmicas combinadas, associadas a exame neurológico quase totalmente normal. A eletromiografia convencional é normal. Uma lista crescente de condições médicas causa NFF. NFF também pode servir como uma terminologia útil para referenciar pequenas discrepâncias nos valores normais de diferentes laboratórios de neurofisiologia. Diferentes técnicas podem evidenciar anormalidades sensitivas e/ou autonçmicas. São necessários mais estudos para refiná-las e para o desenvolvimento de terapias específicas.

Keywords

small fiber neuropathy - unmyelinated nerve fibers

Palavras-chave

neuropatia de pequenas fibras - fibras nervosas amielínicas

Full Text

References

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