• Pariwat Thaisetthawatkul, J Americo M Fernandes Filho, and David N Herrmann.
• Department of Neurological Sciences, 982045 University of Nebraska Medical Center, Omaha, Nebraska, 68164, USA.
• Muscle Nerve. 2013 Dec 1;48(6):883-8.

IntroductionWe evaluated incorporation of the quantitative sudomotor axon reflex test (QSART) into the diagnostic criteria for small fiber neuropathy (SFN) as an addition to quantitative sensory testing (QST) and intraepidermal nerve fiber density (IENFD) testing.MethodsOne hundred one patients with clinically suspected SFN underwent QSART, QST, and skin biopsy. The diagnostic yield of existing SFN criteria in these patients was compared with criteria incorporating QSART. The new combined diagnostic criteria were evaluated.ResultsSFN was diagnosed in 38 of the 101 patients (38%) using current criteria. Addition of QSART existing SFN criteria resulted in an increased diagnostic yield to 67 patients (66%). Applying new SFN criteria requiring abnormality in at least 2 assessments among QSART, QST, and IENFD resulted in a diagnosis of SFN in 57 patients (56%).ConclusionAssessment of both somatic and peripheral autonomic small nerve fibers enhances diagnostic criteria for SFN.Copyright © 2013 Wiley Periodicals, Inc.

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