Neuro Praxis Düsseldorf

Investigation of the "Small Fibers" at the Neuro Praxis Düsseldorf

Tingling, stinging, burning - the cause can be small fiber neuropathy

Parasitic sensations and pain in the context of diseases of the slowly conducting, small-caliber, non-myelinated nerve fibers (small fibers) often puzzles the diagnosis. Thanks to standardized quantitative sensitivity tests, suitable diagnostics are available at the ANS Clinic for patients with small fiber neuropathies. This enables the targeted investigation of neuropathies of the pain-conducting nerve fibers. Small fiber neuropathies can sometimes be very similar to fibromyalgia. Occasionally, small fiber neuropathies express themselves with restlessness of the legs (restless legs symptoms). The precise differentiation of the diseases helps us to treat those affected more successfully and to give better prognostic advice to have the diagnosis of neuropathy examined as the cause of the pain.

Quantitative Sensitivity Test (QST)

This test examines the function of the slowly conducting, non-myelinated nerve fibers (small fibers). These convey vibration, pain and temperature stimuli and control the functions of vegetative organs (e.g. circulation, bladder, gastrointestinal tract, sweat glands). By determining the lower threshold of sensation of different stimulus qualities, i.e. when a stimulus is still being perceived, it is possible to assess whether there is a functional disorder of the small fibers. Comparing the results for different stimuli helps localize the damage in the tissue, spinal cord or brain. The examination is standardized, takes about 45-60 minutes and is non-invasive.

Quantitativer Sensibilitäts-Test (QST)

Mit diesem Test wird die Funktion der langsam leitendenden, nicht-myelinisierten Nervenfasern (Small Fibres) untersucht. Diese vermitteln Vibrations-, Schmerz- und Temperatur-Reize und steuern die Funktionen vegetativer Organe (bspw. Kreislauf, Blase, Magen-Darm-Trakt, Schweißdrüsen). Durch Bestimmung der unteren Empfindungsschwelle verschiedener Reizqualitäten, das heißt, wann ein Reiz gerade noch wahrgenommen wird, lässt sich beurteilen, ob eine Funktionsstörung der Small Fibres vorliegt. Der Vergleich der Ergebnisse für verschiedene Reize hilft bei der Lokalisation der Schädigung im Gewebe, Rückenmark oder Gehirn. Die Untersuchung erfolgt standardisiert, dauert ca. 45-60 Minuten und ist nicht invasiv.

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Prof. Dr. med. Christina Haubrich and Nina Salimi (Specialists in neurology)

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