Small Fiber Neuropathy in the Elderly

Small fiber neuropathy is common and prevalent in the elderly. The disease can be associated with many medical conditions. It often has a negative impact on quality of life due to painful paresthesia, dizziness, and sedative side effects of pain medications. Skin biopsy is the gold standard diagnostic test. Screening for associated conditions is important, because etiology-specific treatment can slow down disease progression and ameliorate symptoms. Adequate pain control can be challenging due to safety and tolerability of pain medications in the elderly. Treatment should be individualized with the goals of controlling underlying causes, alleviating pain, and optimizing daily function.