C-fiber axon reflex flare size correlates with epidermal nerve fiber density in

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J Peripher Nerv Syst. 2009 Dec;14(4):294-299.

C-fiber axon reflex flare size correlates with epidermal nerve fiber density in

human skin biopsies.

Bickel A, Heyer G, Senger C, Maihoefner C, Heuss D, Hilz MJ, Namer B.

Department of Neurology, University of Erlangen-Nuremberg, Germany.

The size of the neurogenic axon reflex flare (ARFS) has been proposed to serve

as a non-invasive measure of C-fiber neuropathies. This idea is based on the

observation that ARFS is often reduced in patients with small-fiber

neuropathies.

In this study, we compared ARFS and electrically evoked axon reflex sweating

with intraepidermal nerve fiber density (IENF) in patients with peripheral

neuropathy in order to validate these methods against an objective standard

method of diagnosing small-fiber neuropathy. ARFS was significantly correlated

with IENF, while axon reflex sweating was not correlated to IENF.

We conclude that measurement of ARFS is a potential objective non-invasive

diagnostic tool for analysis of C-fiber function in patients with small-fiber

neuropathies.