‘Sirim’ (Cold) Pain as a Common Symptom in Korean Patients with Clinically Suspected Small-Fiber Neuropathy
10.3988/jcn.2019.15.4.480
- Author:
Eun Bin CHO
1
;
Jin Myoung SEOK
;
Ju Hong MIN
;
Bum Chun SUH
;
Ki Jong PARK
;
Byoung Joon KIM
Author Information
1. Department of Neurology, College of Medicine, Gyeongsang Institute of Health Science, Gyeongsang National University, Jinju, Korea.
- Publication Type:Original Article
- Keywords:
small fiber neuropathy;
sensory;
autonomic;
cold;
pain;
quality of life
- MeSH:
Axons;
Diagnostic Tests, Routine;
Erythromelalgia;
Health Surveys;
Humans;
Linear Models;
Nerve Fibers, Unmyelinated;
Neuralgia;
Quality of Life;
Reflex;
Risk Factors
- From:Journal of Clinical Neurology
2019;15(4):480-487
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND AND PURPOSE: Diagnosing small-fiber neuropathy (SFN) is challenging because there is no gold-standard test and few diagnostic tests. This study investigated the clinical symptom profile and its associations with the results of quantitative sensory testing (QST) and the quantitative sudomotor axon reflex test (QSART) as well as the quality of life (QOL) in patients with clinically suspected SFN. METHODS: This study involved 63 patients with clinically suspected length-dependent SFN. Assessments were performed using QST, QSART, SFN Symptoms Inventory Questionnaire, Neuropathic Pain Symptom Inventory, ‘Sirim’ frequency and ‘Sirim’ (cold) pain severity, and 36-item Short-Form Health Survey. Multiple logistic and linear regression analyses were performed to predict risk factors for QST or QSART abnormalities and QOL, respectively. RESULTS: ‘Sirim’ and ‘Sirim’ pain was the most-common (84%) and the most-severe complaint (mean score of 6.3 on a numerical rating scale ranging from 0 to 10) in patients with clinically suspected SFN. The findings of QST [cold detection threshold (CDT)] and QSART were abnormal in 71% (n=45/57) and 62% (n=39/56) of the patients, respectively. An abnormal CDT was correlated with more-severe stabbing pain (odds ratio=2.23, 95% CI=1.02–4.87, p=0.045). Restless-leg symptoms (β=−7.077) and pressure-evoked pain (β=−5.034) were independent predictors of the physical aspects of QOL. CONCLUSIONS: ‘Sirim’ pain, similar to cold pain, should be considered a major neuropathic pain in SFN. Among pain characteristics, stabbing pain of a spontaneous paroxysmal nature may be more pronounced in the setting of dysfunctional Aδ fibers with functional autonomic C fibers.
