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

Objective: This study was undertaken to determine how many dyslipidemic patients with negative nerve conduction study (NCS)/electromyogram (EMG) results have reduced epidermal nerve fiber density (ENFD).

Design: Retrospective Cohort.

Setting: Pain management clinic, Clinical laboratory.

Participants: 166 dyslipidemic patients with normal NCS/EMG.

Interventions: Treatment with small fiber neuropathy (SFN) medication: pentoxifylline, alpha-lipoic acid, and topiramate; lifestyle change recommendation.

Main Outcome Measures: ENFD test results (overall assessment: normal, abnormal; values of biopsies at calf, distal thigh, proximal thigh) at baseline (initial test) and after 1 year of treatment. Lab panel results (hyperlipidemia, hypolipidemia).

Results: Out of 166 dyslipidemic patients with normal NCS/EMG, 157 (95%) showed reduced ENFD compared to 9 (5%) patients with normal ENFD results (P<.001). Among 157 dyslipidemic patients with abnormal ENFD results, 98 (62%) patients were length dependent versus 59 (38%) patients who were non-length dependent (P > .05).

Conclusions: In this study, there was a significant difference observed in patients with a history of dyslipidemia and abnormal lipid panel when patients with reductions in their ENFD tests were compared to patients with ENFD results within normal range. There was also determined to be no significant difference in the SFN patients with dyslipidemia histories with regards to length dependent SFN compared to non-length dependent SFN. Our findings indicate that ENFD may become a useful technique for the assessment of SFN in dyslipidemic patients, and strongly supports that dyslipidemia is a cause for SFN.

Level of Evidence: Level I

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/epidermal-nerve-fiber-quantification-in-dyslipidemic-patients/