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The following is a summary of “High Prevalence of Small-Fiber Neuropathy in Patients with Tarlov Cysts: Toward a More Comprehensive Clinical Understanding,” published in the April 2025 issue of Journal of Pain Research by Hulens et al. 

Researchers conducted a retrospective study to explore the prevalence of small-fiber neuropathy (SFN) and the clinical characteristics of patients with Tarlov cysts (PTCs), focusing on SFN symptoms and increased cerebrospinal pressure.  

They reviewed 126 surveys assessing symptoms in women aged 30–69 years with Tarlov cysts (TCs) ≥ 7 mm who sought treatment for chronic pelvic, back or leg pain. Skin biopsy results from 75 patients were also assessed to evaluate intraepidermal nerve fiber density (IENFD).  

The results showed that 80% of PTCs had IENFD < 5th percentile based on Collongues et al’s normative reference data, and 72% based on Lauria et al’s worldwide dataset. Questionnaires indicated high incidences of neuropathic pain (80%), allodynia (76%), pain while sitting (93%), anal sphincter issues (11%), urinary sphincter problems (66%), persistent genital arousal (27%), and restless legs (54%). Autonomic dysfunctions included early satiety (41%), bladder dysfunction (93%), bowel dysfunction (88%), increased sweating (51%), and Raynaud’s phenomenon (45%). Symptoms linked to increased cerebrospinal fluid pressure (CSFP) included headaches (57%), fatigue (86%), cognitive issues (86%), and pulsatile tinnitus (59%).  

Investigators concluded that the study revealed a high prevalence of SFN in PTCs (72–80%) and highlighted a range of symptoms, including bladder, bowel, sphincter, sexual, and local pain, as well as headaches, fatigue, cognitive difficulties, neuropathic pain, and autonomic dysfunctions, potentially linked to elevated CSFP within the nerve root sheath. 

Source: dovepress.com/high-prevalence-of-small-fiber-neuropathy-in-patients-with-tarlov-cyst-peer-reviewed-fulltext-article-JPR