Small fiber neuropathy: from underlying conditions to treatment

Small fiber neuropathy is a disorder of the small nerve fibers, in which patients experience severe pain and complaints of dysfunction of the autonomic nervous system (such as dizziness when standing or intestinal complaints). This dissertation describes the occurrence of underlying disorders in small fiber neuropathy, in which diabetes mellitus, immunological disorders, a vitamin B12 deficiency and certain abnormalities in the hereditary material (sodium channel mutations) were found to occur more frequently than in the general Dutch population. In addition, this thesis shows the current and new treatment options for pain in small fiber neuropathy, such as the medication lacosamide. The dissertation shows that lacosamide is a safe and complication-delaying treatment that can reduce pain in patients with small fiber neuropathy based on a sodium channel mutation in the SCN9A gene.