Small Nerve Fiber Dysfunction in Children and Adolescents-Dr. Swinarska Presentation

Dr. Swinarska Presentation

Pdf Summary

The document discusses small nerve fiber dysfunction, specifically Small Fiber Neuropathy (SFN) in children, from a physiatric perspective. SFN involves the damage of thinly myelinated A-delta fibers, unmyelinated C sensory fibers, and autonomic or trophic fibers, leading to symptoms that can interfere with daily activities and development in children. Despite limited data on SFN in children, it is emerging as a significant condition that requires early diagnosis and management to prevent lifelong complications.<br /><br />The incidence and prevalence of SFN have some data from populations in the Netherlands and the U.S., but information specific to children is scarce, frequently limited to case series or reports. In a study, over half of 41 children with unexplained chronic widespread pain met diagnostic criteria for SFN. SFN symptoms, if untreated, can hinder development, though improving contributing conditions might aid in regrowth and prevent further damage.<br /><br />The treatment and management of SFN in children lack specific guidelines due to insufficient research. Existing treatments are largely extrapolated from adult studies and general pediatric neuropathic pain treatments. Common pharmacological treatments include intravenous immunoglobulins, antidepressants, anticonvulsants, and opioids, among others. Rehabilitation programs are recommended as complementary approaches or alternatives to pharmacological interventions, promoting pain relief and functional improvements through exercise and sensibility stimulation.<br /><br />Erythromelalgia, a subset of conditions associated with SFN, features burning, painful, and swollen feet, relieved by cooling. It is an underrecognized manifestation of SFN. Cognitive-behavioral therapy (CBT) has also shown promise in treating chronic pain in pediatric conditions but has not been extensively studied in SFN in children. The document concludes by emphasizing the need for further research to establish effective treatment protocols for pediatric SFN.

Keywords

Small Fiber Neuropathy

children

nerve dysfunction

A-delta fibers

C sensory fibers

autonomic fibers

pediatric neuropathy

treatment guidelines

erythromelalgia

cognitive-behavioral therapy