Nerve Fiber Density Testing - 12/15

Techniques to measure intraepidermal nerve fiber (IENF) density have led to an improved understanding of the relation between the loss of small nerve fibers and symptoms of peripheral neuropathy. The literature also indicates that low IENF density may provide supportive evidence of a lesion in the peripheral somatosensory system. For example, there is a significant decrease in the average IENF in groups of patients diagnosed with small fiber neuropathy in comparison with groups of controls, and an IENF density of 4 to 8 per mm in the calf is near the 5th percentile of normal values, suggesting an increased probability of small fiber neuropathy below these cutoffs.