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Journal Review: Diagnostic criteria for idiopathic small fiber neuropathy: A systematic review
Journal Review: Diagnostic criteria for idiopathic small fiber neuropathy: A systematic review

Idiopathic small fiber neuropathy (iSFN) lacks broadly accepted diagnostic criteria, which hinders its timely diagnosis and treatment. A systematic literature review was performed to assess the published screening and diagnostic criteria for iSFN, exclud-ing studies where SFN was of well-established etiology. Eighty-four clinical studies and seven guideline/review publications were included in this systematic review. Substantial heterogeneity existed in iSFN diagnostic criteria. The most common set of criteria to diagnose iSFN [presence of any symptoms of iSFN, absence of large fiber involvement, and reduced intraepidermal nerve fiber density (IENFD)] was used in only 14% of studies. Mandatory individual criteria to confirm iSFN included any sensory symptoms (60% of studies), pain (19% of studies), small fiber signs (20% of studies), absence of large fiber signs (62% of studies), reduced IENFD (38% of stud-ies), and autonomic symptoms (1% of studies). This review highlights a clear need for standardized, evidence-based guidelines for diagnosing iSFN.

The AANEM is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The AANEM designates this enduring material for a maximum of 1 AMA PRA Category 1 Credits TM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity. Credit expires 12/1/2023.

No one involved in the planning of this CME activity had any relevant financial relationships to disclose. Any conflicts have been resolved by the Journal in accordance with the Muscle & Nerve editorial process.

Simon Haroutounian, PhD; Marko S. Todorovic, MD, MSCI; Mathias Leinders, PhD; Marta Campagnolo, MD; Jennifer S. Gewandter, PhD, MPH; Robert H. Dworkin, PhD; Roy Freeman, MD.
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