• We investigated three diabetic patients whose neuropathy was characterized by pain,
hypesthesia, and autonomic dysfunction, with preservation of epicritic sensation and muscle-
stretch reflexes. Two sural nerves were studied qualitatively and quantitatively, using teased
fiber, light, and electron microscopical techniques. The most striking alterations were
encountered in unmyelinated and small myelinated fibers. Unmyelinated nerve fiber
sprouting was evident. The clinical features, which suggested small-fiber involvement …