--that complicates the picture in predominantly small-fiber syndromes.

While the majority of people with small-fiber conditions show a length-dependent type of die-back neuropathy, slowly progressive over time and chronic, a small minority present with an all-over body, or at least a beyond stocking/glove, distribution of symptoms. Often, these people have a more acute, or sub-acute, onset than people with length-dependent situations.

There's not a lot of research info out there on this, as it is not anwhere near as common as the small-fiber neuropathies associated with diabetes and vascular autoimmunities. Papers like this are perhaps representative:

http://jnnp.bmj.com/content/72/4/540.abstract

Such syndromes have been likened to a sort of small-fiber sensory Guillain Barre, though distinctions can be made in that other sensory variants of Guillain Barre show evidence of demyelination of larger sensory nerves:

http://www.neurology.org/cgi/content/full/56/1/82

--and the small-fiber variation, by definition, does not involve demyelination. It is thought, though, that both may occur through a molecular-mimicry autoimmune mechanism, are monophasic, and may allow for some degree of recovery, though recovery is often patchy and incomplete.

Dr. Abhey Moghekar of Johns Hopkins has speculated that in at least some of the cases of small-fiber neuropathy that present beyond the extremities the immune attack may be at the level of the dorsal root ganglia. Such situations may provide for less recovery as the damage is to cell bodies rather than to axons, and whiile the latter may regenerate if the rest of the nerve is intact, damage to the cell body (the soma) generally cannot be healed--the cell tends to disintegrate. However, as he once joked to me, evidence to distinguish this is hard to come by with current imaging technology and awaits my autopsy (that's neuroloigst humor for you).

It is known that this type of wider body presentation is relatively common in patients in which symptoms can be traced to gluten-sensitivity/celiac.

See:

http://jnnp.bmj.com/content/79/2/163.abstract

http://www3.interscience.wiley.com/c...6297/HTMLSTART