What is Epidermal Nerve Fiber Density (ENFD) testing

Epidermal Nerve Fiber Density (ENFD) testing is the analysis of a 3mm punch biopsy of skin to quantify the number of unmyelinated C-fibers and myelinated A delta-fibers within the epidermis.

The skin has a rather consistent number of epidermal nerves at specific anatomical sites. This density is also found to be consistent between different age groups and genders. Small fiber peripheral neuropathy is indicated when this density runs below the normal curve. Also, prior to the onset of symptoms, degeneration within the epidermal nerves may predict peripheral neuropathy.

ENFD is not new technology actually; neurologists have used this technique for over 15 years. Peripheral neuropathy begins with the body’s smallest and most distal nerves, which are the C-fibers and A delta-fibers, and then progresses proximally in a stocking-like distribution.

Epidermal Nerve Fiber

Some most common causes of small fiber peripheral neuropathy include:

  • Diabetes mellitus, Type I and II
  • Metabolic syndrome
  • Idiopathic/familial
  • Alcohol abuse
  • Human Immunodeficiency Virus
  • Amyloidosis
  • Pharmacologic toxins (metronidazole)
  • Solvent exposure
  • Chemotherapy-induced
  • Leprosy
  • Vasculitis
  • Autoimmune (various disorders)

Advantages of ENFD

  • Purely objective measure of small nerve disease
  • Possibly might be able to predict neuropathy
  • Easily performed in an office setting
  • Provides a baseline so that the benefits of therapeutic agents may be measured
  • Highly specific and sensitive
  • Quick and easy to perform

For an appointment with one of our doctors at one of our nine Southern California locations please call 310-828-0011 or visit us at www.footankleinstitute.com

The UFAI Education Team

The UFAI Education Team

For almost fifteen years, University Foot and Ankle Institute and their nationally recognized physicians have been providing the most technologically advanced medical care for the foot and ankle with the highest success rates in the country.

As a teaching institution, University Foot and Ankle Institute’s Fellowship Program is among the most advanced in the nation.

We at UFAI are driven to get our patients back to their normal activities with the highest level of function, in the least amount of time, using the least invasive treatments possible. From start to finish, we are with you every step of the way.

The UFAI Education Team works to help empower our patients and website visitors with the most up-to-date information about foot and ankle conditions, treatment options, recovery and injury prevention. Our goal is to pass on truly useful information to our readers.

We hope you enjoy our work and find it of value. Please let us know!
The UFAI Education Team

One comment

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