A Systematic Review of Pharmacologic and Rehabilitative Treatment of Small Fiber Neuropathies

The aim of this systematic review is to guide the physician in defining the pharmacologicand rehabilitative therapeutic approaches for adopting the best strategies described in the currentliterature. The search was conducted in PubMed, EMBASE, Cochrane Library and Web of Scienceto identify the treatment of small fiber neuropathies. Two reviewers independently reviewed andcame to a consensus on which articles met inclusion/exclusion criteria. The authors excluded theduplicates, animal studies and included the English articles in which the treatment of patients withsmall fiber neuropathies was described. The search identified a total of 975 articles with the keywords“small fiber neuropathy” AND “rehabilitation” OR “therapy” OR “treatment”. Seventy-eight selectedfull-text were analyzed by the reviewers. Forty-two publications met the inclusion criteria and wereincluded in the systematic review to describe the rehabilitative and pharmacologic treatment of smallfiber neuropathies. Despite the range of different protocols of treatment for small fiber neuropathy,other robust trials are needed. In addition, always different therapeutic approaches are used; a uniqueprotocol could be important for the clinicians. More research is needed to build evidence for the beststrategy and to delineate a definitive therapeutic protocol.