Small fiber neuropathy in unexpected clinical settings: a review

Majid Ghasemi, Yusuf A. Rajabally*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


Small fiber neuropathy (SFN) is being recognized with increasing frequency in neuromuscular practice due to improved diagnostic techniques. Although there are some common etiologies, up to one‐third of cases are considered idiopathic. In recent years, several disorders have unexpectedly been reported in association with SFN, on clinical grounds and complementary investigations, including quantitative sensory testing, intraepidermal nerve fiber density and confocal corneal microscopy. Knowledge of these disorders is important in clinical practice as increased awareness enables prompt diagnosis of SFN in these settings and early optimal therapeutic management of affected patients. Furthermore, these new developments may lead to a better understanding of the pathophysiologic mechanisms underlying SFN in these different disorders as well as, in some cases, an expanded spectrum of affected organs and systems. This article reviews these reported associations, their possible pathophysiologic bases, and the potential resulting management implications.
Original languageEnglish
Pages (from-to)167-175
Number of pages9
JournalMuscle and Nerve
Issue number2
Early online date14 Jan 2020
Publication statusPublished - 1 Aug 2020

Bibliographical note

This is the peer reviewed version of the following article: Ghasemi, M. and Rajabally, Y.A. (2020), Small fiber neuropathy in unexpected clinical settings: a review. Muscle Nerve. Accepted Author Manuscript., which has been published in final form at  This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.


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  • Parkinson disease
  • REM sleep behavior disorder
  • amyotrophic lateral sclerosis
  • inflammatory neuropathy
  • small fiber neuropathy
  • vaccination


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