Disclosures: Francis P. Lagattuta, MD: Nothing to disclose

Objective: To determine the incidence of autonomic neuropathy and small fiber neuropathy on patients with symptoms combatable with autonomic neuropathy.

Design Retrospective cohort

Setting: Pain management clinic

Participants : 35 patients who answered positively to autonomic neuropathy questions.

Interventions: Not applicable.

Main Outcome Measures: Patients had a skin biopsy to determine if they have length dependent or nonlength dependent Small Fiber Neuropathy. They also had autonomic testing including Q-Sweat, heart rate to deep breathing, Valsalva maneuver, and tilt table tests.

Results: 35 patients had an answered positive to questions with symptoms of autonomic neuropathy and underwent both a skin biopsy and all 4 autonomic tests. 10 (29%) patients were diabetic. 23 patients (66%) had abnormal autonomic tests. 19 patients (54%) had abnormal Epidermal Nerve Fiber Densities (ENFD). 12 (34%) patients had a normal ENFD and abnormal autonomic testing. 7 patients (20%) had length dependent small fiber neuropathy and abnormal automonic testing. 4 (11%) patients had nonlength dependent small fiber neuropathy and abnormal autonomic testing. 3 (9%) patients had length dependent small fiber neuropathy and normal autonomic testing. 5 (14%) patients had nonlength dependent small fiber neuropathy and normal autonomic testing. 4 (11%) of patients had normal tests for both ENFD and autonomic testing.

Conclusions: Patients with symptoms of autonomic neuropathy should be tested for autonomic neuropathy and small fiber neuropathy. This includes both diabetics and nondiabetics so treatment can be started immediately.

Level of Evidence: Level I

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/incidence-of-autonomic-neuropathy-among-patients-with-small-fiber-neuropathy/