title: Acute steroid responsive small-fiber sensory neuropathy: a new entity?
abstract: Small-fiber neuropathy is often idiopathic and commonly follows a chronic course. Treatment is often effective in treating the core symptom of pain, but it has no effect on the pathologic process. We describe four patients with acute small-fiber neuropathy who responded dramatically to steroid therapy. All patients had acute onset neuropathic pain, normal nerve conduction studies, and evidence of small-fiber dysfunction in quantitative sensory testing and skin biopsy. Symptoms were distal and symmetrical in three patients and generalized in one patient. In two cases, the neuropathy presented as an erythromelalgia-like syndrome. Marked clinical improvement occurred 1-2 weeks after oral prednisone therapy was initiated. Three patients remained symptom free, and one patient experienced recurrence of neuropathy after prednisone was tapered.
authors.affiliation: Department of Neurology, Wolfson Medical Center, Holon, Israel. dabbyr@netvision.net.ildabbyr@netvision.net.il
authors.forename: Ron
authors.initials: R
authors.lastname: Dabby
authors.forename: Ronit
authors.initials: R
authors.lastname: Gilad
authors.forename: Menachem
authors.initials: M
authors.lastname: Sadeh
authors.forename: Yair
authors.initials: Y
authors.lastname: Lampl
authors.forename: Nathan
authors.initials: N
authors.lastname: Watemberg
mesh_terms: D000293:Adolescent; D000328:Adult; D001706:Biopsy; D062109:Dermatologic Surgical Procedures; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000188:drug therapy / Q000209:etiology; D009475:Neurons, Afferent / Q000187:drug effects / Q000473:pathology*; D011115:Polyneuropathies / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D011241:Prednisone / Q000627:therapeutic use*; D012867:Skin / Q000294:innervation
chemical_list: D005938:Glucocorticoids; D011241:Prednisone