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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2022; 80(05): 545
DOI: 10.1590/0004-282X-ANP-2021-0327
Editorial

Pain-related nociceptive evoked potential and skin wrinkle test in small fiber neuropathy

Potencial evocado nociceptivo relacionado à dor e teste de enrugamento cutâneo na neuropatia de fibras finas
Otto Jesus HERNÁNDEZ FUSTES 
1   Universidade Federal do Paraná, Complexo Hospital de Clínicas, Departamento de Clínica Médica, Serviço de Neurologia, Serviço de Doenças Neuromusculares e Desmielinizantes, Curitiba PR, Brazil.
,
Cláudia Suemi Kamoi KAY 
1   Universidade Federal do Paraná, Complexo Hospital de Clínicas, Departamento de Clínica Médica, Serviço de Neurologia, Serviço de Doenças Neuromusculares e Desmielinizantes, Curitiba PR, Brazil.
,
Paulo José LORENZONI 
1   Universidade Federal do Paraná, Complexo Hospital de Clínicas, Departamento de Clínica Médica, Serviço de Neurologia, Serviço de Doenças Neuromusculares e Desmielinizantes, Curitiba PR, Brazil.
,
Renata Dal-Prá DUCCI 
1   Universidade Federal do Paraná, Complexo Hospital de Clínicas, Departamento de Clínica Médica, Serviço de Neurologia, Serviço de Doenças Neuromusculares e Desmielinizantes, Curitiba PR, Brazil.
,
Michelle Zonkowski RIBAS 
2   Universidade Federal do Paraná, Curitiba PR, Brazil.
,
Lineu Cesar WERNECK 
1   Universidade Federal do Paraná, Complexo Hospital de Clínicas, Departamento de Clínica Médica, Serviço de Neurologia, Serviço de Doenças Neuromusculares e Desmielinizantes, Curitiba PR, Brazil.
,
Rosana Herminia SCOLA 
1   Universidade Federal do Paraná, Complexo Hospital de Clínicas, Departamento de Clínica Médica, Serviço de Neurologia, Serviço de Doenças Neuromusculares e Desmielinizantes, Curitiba PR, Brazil.
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A 58-year-old woman with clinically probable small fiber neuropathy (SFN)[1], with normal electroneuromyography, was evaluated with pain-related nociceptive evoked potential (PREP) with a concentric planar electrode stimulation on the dorsum of the hands and feet[2] and skin wrinkle test (SWT)[3]. The PREP showed N1 latency delay ([Figure 1]), compatible with the change in SWT induced by water, which indicated a Grade 0 pattern ([Figure 2]), as can be seen in sympathetic autonomic small fiber dysfunction.

Zoom Image
Figure 1 Pain-related nociceptive evoked potential.
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Figure 2 Skin wrinkle test. Patient (C and D). Normal test (A and B).

New electrophysiological tools, combined with SWT and specific neurological examination, contribute to the diagnosis of SFN.

Multiple-choice questions with related answers are given in Supplementary Material. The following material is available online for this article: https://www.arquivosdeneuropsiquiatria.org/wp-content/uploads/2022/02/ANP_2021327_material-suplementar_16-02.pdf


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Conflict of interest:

There is no conflict of interest to declare.

Authors’ contributions:

All authors worked extensively on the manuscript and approved this submitted version; OJHF: conceived the idea for the article, which was written and critically reviewed by all authors.



Address for correspondence

Otto J. H. Fustes

Publikationsverlauf

Eingereicht: 11. August 2021

Angenommen: 27. Oktober 2021

Artikel online veröffentlicht:
06. Februar 2023

© 2022. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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Zoom Image
Figure 1 Pain-related nociceptive evoked potential.
Zoom Image
Figure 2 Skin wrinkle test. Patient (C and D). Normal test (A and B).