Neuropatía de fibras pequeñas: una revisión / Small fibre neuropathy: a review

La neuropatía de fibras pequeñas es una afectación del sistema nervioso periférico cuya principal manifestación es un cuadro de dolor neuropático crónico, acompañado generalmente de alteraciones del sistema nervioso autónomo. Esta enfermedad afecta a fibras nerviosas mielinizadas (Adelta) y no mielinizadas (C), de pequeño calibre. Sus causas pueden ser primarias o secundarias a trastornos del metabolismo, infecciones, enfermedades autoinmunes, neurológicas o tóxicos. Los estudios neurofisiológicos habituales suelen ser negativos. El diagnóstico puede realizarse con exploraciones complementarias de difícil acceso desde la atención primaria, como la microneurografía, test con estímulos sensitivos y otras, aunque la prueba más utilizada es la biopsia cutánea. El tratamiento debe dirigirse a las causas y/o a los síntomas neurológicos. Dada la variabilidad de síntomas con los que puede iniciarse, creemos que es importante conocer esta entidad para aumentar la sospecha clínica, orientar el diagnóstico y poder ofrecer la posibilidad de tratamiento

Small fibre neuropathy is a disorder of the peripheral nervous system for which main clinical manifestation is chronic neuropathic pain, often accompanied by alterations of the autonomic nervous system. This disease affects the small diameter myelinated (ADelta) and non-myelinated nerve fibres (C). Its causes are primary or secondary, such as metabolism defects, infection, and autoimmune, neurological or toxic diseases, among others. Routine neurophysiological tests are usually negative. Diagnosis can be made with complementary tests which are difficult to access from Primary Health Care. These include microneurography, and the sensory stimulation test; but the most used technique is the skin biopsy. Treatment is directed at the causes and the neurological symptoms. Due to the variability of symptoms that can be presented, the importance of being aware of this condition is emphasised in order to reach a diagnosis and offer the appropriate treatment

[Small fibre neuropathy: A review]. / Neuropatía de fibras pequeñas: una revisión.

Small fibre neuropathy is a disorder of the peripheral nervous system for which main clinical manifestation is chronic neuropathic pain, often accompanied by alterations of the autonomic nervous system. This disease affects the small diameter myelinated (Aδ) and non-myelinated nerve fibres (C). Its causes are primary or secondary, such as metabolism defects, infection, and autoimmune, neurological or toxic diseases, among others. Routine neurophysiological tests are usually negative. Diagnosis can be made with complementary tests which are difficult to access from Primary Health Care. These include microneurography, and the sensory stimulation test; but the most used technique is the skin biopsy. Treatment is directed at the causes and the neurological symptoms. Due to the variability of symptoms that can be presented, the importance of being aware of this condition is emphasised in order to reach a diagnosis and offer the appropriate treatment.

[Functional classification of chronic alcoholic hepatopathy in primary care]. / Clasificación funcional de la hepatopatía crónica alcohólica en atención primaria.

OBJECTIVE: To evaluate the use of Pugh's Classification in assessing patients with diffuse alcoholic Chronic Hepatopathy in the out-patient context. DESIGN: Descriptive-retrospective study. SITE. The Base Health Area of "La Mina" in Barcelona. PATIENTS OR OTHER PARTICIPANTS: 143 patients over the age of 14 diagnosed as suffering diffuse chronic Hepatopathy were identified. 37 of these were excluded because of lack of data. MAIN MEASUREMENTS AND RESULTS: The following data were gathered: those relating to semeiology, anamnesis, quantifying alcoholic intake, where the original diagnosis was made, how rapidly the condition evolved, laboratory and complementary explorations' parameters. Out of the 106 patients studied 71 (67%) were classified in group A; 22 (21%) in B and 13 (12%) in C. No significant differences were found in relation to age or sex. Significant differences concerning the speed of the condition's evolution and the average intake in grammes of alcohol per day were observable. The number of hospital admissions increased as the patient's functional stage became worse and complications increased. CONCLUSIONS: Pugh's test was shown to be useful in the out-patient context for classifying patients suffering chronic diffuse Hepatopathy in line with the severity of their condition.