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Background <p>Small fiber neuropathy is a subtype of peripheral neuropathy. Diagnosis of small fiber neuropathy is important for detecting the origin of neuropathic pain in patients with normal standard nerve conduction studies. The cutaneous silent period (CSP) is an inhibitory spinal reflex. It is considered an easily applied, readily available method for the evaluation of small myelinated A-delta fibres. Seventy-six subjects were included; 38 relapsing-remitting multiple sclerosis (RRMS) cases with clinically suspected small fiber neuropathy were compared to 38 healthy controls within an age range of 18–50 years. Patients underwent Expanded Disability Status Scale and were administered Lead’s assessment of neuropathic symptoms and signs pain scale for evaluation of small fiber neuropathy.</p> Results <p>There was a significant delay in CSP onset latency in the lower limbs more than the upper limbs. Also, there was a significant difference in onset latency between upper and lower limbs in cases compared to controls.</p> Conclusion <p>The cutaneous silent period seems to be a promising method for evaluation of small fiber neuropathy in RRMS patients. The potential usefulness of the CSP arises from being a simple, non-invasive method for assessment of small peripheral nerve fibers that standard nerve conduction studies cannot detect.</p>

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The cutaneous silent period in multiple sclerosis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月24日

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  • Reem Atef ElHadidy,
  • Sara Mohamed Kotb,
  • Amira Ahmed Labib,
  • Amr Mohamed Fouad,
  • Alshaimaa Sobhi Khalil

摘要

Background

Small fiber neuropathy is a subtype of peripheral neuropathy. Diagnosis of small fiber neuropathy is important for detecting the origin of neuropathic pain in patients with normal standard nerve conduction studies. The cutaneous silent period (CSP) is an inhibitory spinal reflex. It is considered an easily applied, readily available method for the evaluation of small myelinated A-delta fibres. Seventy-six subjects were included; 38 relapsing-remitting multiple sclerosis (RRMS) cases with clinically suspected small fiber neuropathy were compared to 38 healthy controls within an age range of 18–50 years. Patients underwent Expanded Disability Status Scale and were administered Lead’s assessment of neuropathic symptoms and signs pain scale for evaluation of small fiber neuropathy.

Results

There was a significant delay in CSP onset latency in the lower limbs more than the upper limbs. Also, there was a significant difference in onset latency between upper and lower limbs in cases compared to controls.

Conclusion

The cutaneous silent period seems to be a promising method for evaluation of small fiber neuropathy in RRMS patients. The potential usefulness of the CSP arises from being a simple, non-invasive method for assessment of small peripheral nerve fibers that standard nerve conduction studies cannot detect.