Undiagnosed Small-Fiber Polyneuropathy: Is it a Component of Gulf War Illness?

The term small-fiber polyneuropathy (SFPN) refers to body-wide dysfunction/degeneration of small-diameter axons that transmit pain and control the body s autonomic functions. The vague, widespread symptoms of SFPN overlap with those of Gulf War Illness (GWI). We propose that there may be a SFPN component to GWI. To diagnose SFPN in Gulf War-ill veterans, we tested normal control subjects and patients with definite SFPN to compare the sensitivity and specificity of the best known tests. We also tested Gulf War veterans with and without GWI to identify how often this neurological illness is masquerading as GWI, and we applied the same tests (autonomic function test, skin biopsy, and neurological exam) to subjects diagnosed with fibromyalgia (FM). We also characterized our subjects' health with a series of validated questionnaires. By doing so, we found markers of SFPN in Gulf War veterans and FM patients in approximately the same ratio.
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