Navigating the Enigma: A Case Study on Unmasking Idiopathic Small Fiber Sensory Neuropathy in a 69-year-old Patient Amidst a Complex Web of Paresthesia

Abstract

This case report describes one case of idiopathic small fiber sensory neuropathy (ISFSN) in a 69 years old female, who also has a medical history of hypertension and hyperlipidemia. The patient had symptoms of periodic paresthesia and tingling in her lower extremities, occasional discomfort in the hip and lumbar region, as well as bilateral muscular spasms and rigidity in the calves. Despite numerous treatment modalities, the patient's symptoms exhibited a progressive deterioration, indicating the presence of progressive neuropathy. The absence of an underlying reversible cause was confirmed using laboratory tests, imaging, and electrodiagnostic examinations. The patient exhibited a positive response to the increase in gabapentin dosage administered by her neurologist, subsequently resulting in the identification of the condition as ISFSN. The case study illustrates the complicated aspects of clinical scenarios frequently found in primary care settings, emphasizing the importance of investigating less prevalent diseases when conventional treatment methods fail. This particular situation highlights the imperative for further research in ISFSN, to identify potentially reversible components and assess the efficacy of various therapeutic approaches.