7. Use of Skin Biopsy in the Diagnosis of Small Fibre Neuropathy

  1. Nils Erik Gilhus MD, PhD Professor13,
  2. Michael P. Barnes MD, FRCP Professor of Neurological Rehabilitation Medical Director14 and
  3. Michael Brainin MD Professor15
  1. G. Lauria1,
  2. S. T. Hsieh2,
  3. O. Johansson3,
  4. W. R. Kennedy4,
  5. J. M. Leger5,
  6. S. I. Mellgren6,
  7. M. Nolano7,
  8. I. S. J. Merkies8,
  9. M. Polydefkis9,
  10. A. G. Smith10,
  11. C. Sommer11 and
  12. J. Valls-Solé12

Published Online: 6 SEP 2010

DOI: 10.1002/9781444328394.ch7

European Handbook of Neurological Management, Second Edition

European Handbook of Neurological Management, Second Edition

How to Cite

Gilhus, N. E., Barnes, M. P. and Brainin, M. (2010) Use of Skin Biopsy in the Diagnosis of Small Fibre Neuropathy, in European Handbook of Neurological Management, Second Edition, Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781444328394.ch7

Author Information

  1. 13

    Department of Clinical Medicine, University of Bergen and Department of Neurology, Haukeland University Hospital, Bergen, Norway

  2. 14

    University of Newcastle, Hunters Moor Neurorehabilitation Ltd, Newcastle upon Tyne, UK

  3. 15

    Department of Clinical Medicine and Prevention, and Center for Clinical Neurosciences, Donau-Universität Krems, Department of Neurology, Landesklinikum Donauregion Tulln Tulln, Austria

Author Information

  1. 1

    IRCCS Foundation, ‘Carlo Besta’ Neurological Institute, Milan, Italy

  2. 2

    National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan

  3. 3

    Karolinska Institute, Stockholm, Sweden

  4. 4

    University of Minnesota, Minneapolis, USA

  5. 5

    Hôpital de la Salpêtrière, Paris, France

  6. 6

    University of Tromsø, Norway

  7. 7

    Salvatore Maugeri Foundation, IRCCS, Center of Telese Terme, Italy

  8. 8

    Spaarne Hospital Hoofddorp, Spaarnepoort 1, The Netherlands

  9. 9

    The Johns Hopkins University School of Medicine, Baltimore, MD, USA

  10. 10

    University of Utah, Salt Lake City, UT, USA

  11. 11

    University of Würzburg, Germany

  12. 12

    Hospital Clinic Barcelona, Spain

Publication History

  1. Published Online: 6 SEP 2010
  2. Published Print: 15 OCT 2010

ISBN Information

Print ISBN: 9781405185332

Online ISBN: 9781444328394



  • skin biopsy use - in diagnosis of small fibre neuropathy;
  • document, written under auspices of European Federation of the Neurological Societies (EFNS);
  • data extraction, carried out - and compared among each member of task force;
  • clinical applications of skin biopsy in SFN - using similar inclusion criteria for patients;
  • perform skin biopsy and choice of biopsy location;
  • less invasive sampling method - removal of epidermis alone by applying a suction capsule to skin;
  • quantification of sweat gland innervation;
  • IENF morphometry and measurement reliability;
  • normative reference values - Bright-field immunohistochemistry;
  • correlation with small fibre - related evoked potentials


This chapter contains sections titled:

  • Objectives

  • Search strategy

  • Method for reaching consensus

  • Definition of small fibre neuropathy

  • Methological issues

  • Normative reference values

  • Diagnostic yield of skin biopsy

  • Correlation between IENF density and other measures of neuropathy

  • Skin biopsy as am easure of outcome

  • EFNS/PNS standards

  • Proposal for new studies

  • References