Small fiber neuropathy as a part of fibromyalgia or a separate diagnosis?

Fibromyalgia (FM) is a chronic disease characterized mainly by widespread pain, fatigue and cognitive disorders. Small Fiber Neuropathy (SFN) is a generalized sensory nerve disorder with structural and functional nerve abnormalities manifesting themselves as sensory disorders such as allodynia, burning, disturbances in thermal sensation, numbness, paresthesia and hyperesthesia. Small fiber neuropathy may also manifest itself with the restless leg syndrome, dry eyes and mouth, gastroenteric symptoms, problems with bladder control, palpitations or syncope. Clinical features of small fiber neuropathy are also presented by some of fibromyalgia patients. The SFN diagnostics is essentially simple and based on symptom analysis and skin punch biopsy assessment. The confirmation of SFN in fibromyalgia patients may influence their treatment. In this article we present a problem of diagnosis and treatment of small fiber neuropathy; we also discuss a link between fibromyalgia and this type of neuropathy.