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Muscle Nerve. 2014 May;49(5):757-9. doi: 10.1002/mus.24156. Epub 2014 Jan 28.

Small nerve fiber involvement in patients referred for fibromyalgia.

Author information

1
Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.

Abstract

INTRODUCTION:

Fibromyalgia (FM) is a chronic syndrome characterized by widespread pain often accompanied by other symptoms suggestive of neuropathic pain. We evaluated patients for small fiber neuropathy (SFN) who were referred for fibromyalgia (FM).

METHODS:

We studied 20 consecutive subjects with primary FM. Patients underwent neurological examination, nerve conduction studies, and skin biopsies from distal leg and thigh.

RESULTS:

Electrodiagnostic studies were normal in all patients. SFN was diagnosed in 6 patients by reduced epidermal nerve fiber density. These patients also showed abnormalities of both adrenergic and cholinergic fibers.

CONCLUSIONS:

A subset of FM subjects have SFN, which may contribute to their sensory and autonomic symptoms. Skin biopsy should be considered in the diagnostic work-up of FM.

KEYWORDS:

autonomic dysfunction; fibromyalgia; neuropathic pain; skin biopsy; small fiber neuropathy

PMID:
24469976
DOI:
10.1002/mus.24156
[Indexed for MEDLINE]
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