Approximately 40% of “Fibromyagia” cases are actually small fiber neuropathy (SFN). There is now evidence of how this type of neuropathy progresses. 75% remain stable and 25% progress into large fibers.
Eur Neurol. 2018 Mar 8;79(3-4):161-165.
Long-Time Course of Idiopathic Small Fiber Neuropathy.
Flossdorf P et al.
- 16 patients with documented long-time course of idiopathic SFN
- as 75% remained stable they considered it “a benign disease course in the majority of patients without severely limiting the quality of life”.
Comment – doesn’t deal with pain issue which in females frequent B12 shots, perhaps 100 mg B6/day, osto-d2 50,000 u/week, testosterone gel 0.2 mls/day, and gabapentin/lyrica and amitriptyline/cymbalta might help. For elderly, Palmitoylethanolamide (PEA) 400 mg 3x/day might be worth a try. The progressive form might be Chronic demyelinating inflammatory polyneuropathy (CIDP) which benefits from gamma globulin infusions or plasmaphoresis and 4 day monthly pulse steroids.