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16) When there are abnormal nerve growth and elevated levels of peripheral nerve sensitization, the nerves most often recruited are C-fibers, unmyelinated fibers largely associated with both peripheral and central neuropathic pain.
Patients with CIPA show an absence of unmyelinated fibers and loss of small myelinated ones.
Electrophysiological testing to measure peripheral nerve conduction properties is not a viable alternative because current methods lack the sensitivity required to detect damage to small, unmyelinated fibers, especially in early stages of disease.