Detection of small nerve fiber neuropathies

The peripheral autonomic neuropathy is a major complication of diabetes.

The sweat glands are innervated by sympathetic unmyelinated nerve fibers of small diameter.

Exploring the sweat function was proposed to evaluate the severity of autonomic neuropathy. [1]

Neuropathic involvement of small fibers develops very early in patients with diabetes [2].

We find these impairments in other pathologies such as:

AmyloidosisInfections (Lyme Disease, HIV)
Autoimmune DiseasesCertain Medications (Chemotherapy Drugs)
Inherited DisordersAlcoholism

The Impeto technology allows to evaluate small fiber neuropathy by studying the sweat function.

Symptoms of peripheral autonomic neuropathies

The table below shows some symptoms associated with peripheral autonomic neuropathies:

Body SystemSymptoms
Stomach and intestinesConstipation (hard stools)
Diarrhea (loose stools)
Feeling full after only a few bites (early satiety)
Nausea after eating
Problems controlling bowel movements
Swallowing problems
Swollen abdomen
Vomiting of undigested food
Heart and lungsAbnormal heart rate or rhythm
Blood pressure changes with position (orthostatic hypotension)
Dizziness when standing
High blood pressure
Shortness of breath with activity or exercise (exercise intolerance)
BladderDifficulty beginning to urinate
Feeling of incomplete bladder emptying
Leaking urine (incontinence)
OtherSweating too much or not enough
Heat intolerance brought on with activity and exercise
Sexual problems including erection problems
Vaginal dryness and orgasm difficulties
Sluggish pupillary reflex
Weight loss without trying


[1] Low PA. Evaluation of sudomotor function. Clin Neurophysiol 2004;115:1506-13.
[2] Tesfaye S, Chaturvedi N, Eaton SE, et al; EURODIAB Prospective Complications Study Group. Vascular risk factors and diabetic neuropathy. N Engl J Med 2005;352:341-50.

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