Small Nerve Fiber Dysfunction in Children and Adolescents-Session recording

Video Transcription

Video Summary

The presentation delves into the understanding and diagnosis of small fiber neuropathy, particularly focusing on pediatric cases. Small fiber neuropathy is characterized by damage to the small sensory, autonomic, and trophic fibers, which can cause a range of symptoms including pain, tingling, temperature sensitivity, and autonomic dysfunctions such as sweating irregularities, gastrointestinal issues, and cardiovascular symptoms. The presented case of a 17-year-old female highlights the challenges in diagnosing this condition, as she exhibited symptoms like intermittent pain and numbness, which were initially misunderstood and led to multiple specialist consultations without a firm diagnosis.<br /><br />Diagnosis in children is particularly challenging due to their limited ability to describe symptoms effectively. Multiple diagnostic modalities are used, including skin biopsies to assess nerve fiber density, thermoregulatory sweat tests, and various physiological tests such as head-up tilt, Valsalva maneuver, and pupillometry. Despite the difficulties in testing and diagnosis, it's crucial for pediatric patients to be accurately diagnosed and treated to prevent progression and permanent damage. However, evidence-based treatment options specific to pediatric small fiber neuropathy remain limited. Treatments often involve a combination of pharmacological therapies—such as immunoglobulins, steroids, and various pain relief medications—and non-pharmacological approaches like cognitive behavioral therapy and specialized rehabilitation programs.<br /><br />The presentation calls for more research and evidence to develop definitive treatment protocols for pediatric small fiber neuropathy, stressing the need for accurate and prompt diagnosis to improve patients’ quality of life and long-term health outcomes. Despite the scarcity of data, rehabilitation and cognitive behavioral therapy are recommended as part of a holistic treatment approach.

Keywords

small fiber neuropathy

pediatric cases

diagnosis

autonomic dysfunction

symptoms

skin biopsies

nerve fiber density

thermoregulatory sweat tests

pharmacological therapies

cognitive behavioral therapy

rehabilitation programs

treatment protocols

pediatric health

research