Small fiber neuropathy is one of those conditions in neurology that can feel frustratingly intangible. Even for patients with severe neuropathic pain and autonomic symptoms, in about half of cases, the usual lab testing doesn't reveal a cause. There's increasing evidence that autoimmunity may be a factor in some of these cases of idiopathic small fiber neuropathy, but how to test and who to treat with immunosuppression is less clear. Our guest today, Anne Louise Oaklander, is an Associate Professor of Neurology at Massachusetts General Hospital and an Assistant in Neuropathology. She's known for her work on small fiber neuropathies and in this episode we'll talk about new autoantibodies associated with small fiber neuropathy and where we are in treating this challenging condition.