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The Center for Peripheral Neuropathy and Autonomic Disorders

Center for Neurosciences

It is estimated that at least a million people in the United States are affected by peripheral neuropathy and autonomic disorders. Yet, because there are more than 100 known causes for peripheral neuropathy and it has such varied symptoms, many with small fiber neuropathy or
autonomic disorders remain undiagnosed and commonly are labeled as having anxiety, fibromyalgia, and functional disorders.

At the Center for Peripheral Neuropathy and Autonomic Disorders (CPND), we directly collaborate with the expert team at Mass General Brigham to provide you access to the latest in comprehensive, objective diagnostic testing and advanced care for your small fiber neuropathy and autonomic disorders.

Our experienced and nationally recognized team knows how critical it is to assure you have the right treatment for your actual neurological syndrome.

What is Peripheral Neuropathy?

Peripheral neuropathy is caused by damage to the nerves in your body, primarily in your arms and legs. Although there are dozens of causes, the most common ones are diabetes and borderline diabetes. Other causes include autoimmune diseases, gluten sensitivity, vitamin deficiencies, toxins, genetics, and some medications, such as chemotherapy agents.

We all have different types of nerve fibers, which simply could be divided into large and small fibers. Symptoms of large fiber neuropathy include lack of sensation in your hands and feet, difficulty to maintain balance, muscle weakness and nerve pain.

At CPND, nerve conduction studies and electromyography (EMG) are used to diagnose large fiber neuropathy.

For those with small fiber neuropathy, your symptoms can include numbness, a feeling of pins and needles, burning sensations, cold sensations in your hands and feet, or skin itching.

Still others, with erythromelalgia, another small fiber neuropathy disorder, may experience a burning sensation in your hands and your feet changing skin color to red.

Complex regional pain syndrome (CRPS), another specific type of small fiber neuropathy, is mostly localized to a limited area in the body.

Autonomic Disorders

Your autonomic nervous system is part of the nervous system, which controls many of your body’s functions, including your blood pressure and heart rate control, sweating, body temperature regulation, regulating blood flow to your muscles and brain, digestive tract motility, sexual and bladder function, sweat and tear gland functions.

If you’re affected by autonomic dysfunction, you may have lightheadedness upon standing, shortness of breath on exertion with normal heart and lung function, fainting spells, increased or decreased sweating, dry eyes and dry mouth, difficulty to maintain body temperature, delayed stomach emptying after eating, constipation or diarrhea, bladder dysfunction, pelvic pain, erectile dysfunction in men, painful intercourse in women, and many other symptoms.

CPND’s comprehensive, state-of-the art diagnostics and treatments include:

  1. Nerve Conduction Studies and Electromyography for the diagnosis of large fiber neuropathy
  2. Skin biopsy to test for small fiber neuropathy
  3. Autonomic Lab with Autonomic Reflex Screen, also known as autonomic function testing, for patients 12 years and older for evaluation of dysfunction of autonomic nervous system including POTS (Postural orthostatic tachycardia syndrome).
  4. Full-time clinic led by Dr. Farhad, Kate Reid, NP, and Jessica Gaudiosi, PA-C, to evaluate patients and offer appropriate treatment options.

Related Websites

Autonomic Disorders: Dysautonomia International

Small Fiber Neuropathy: Neuropathy Commons

Support group: POTS support group of the Seacoast

Contact: Laura at


Khosro Farhad, MD

Wentworth Health Partners Coastal Neurology Services

Dover, NH 03820

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PA-C Neurology

Jessica Gaudiosi, PA-C

Wentworth Health Partners Coastal Neurology Services

Dover, NH 03820

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Kathleen Reid, APRN

Wentworth Health Partners Coastal Neurology Services

Dover, NH 03820

See Profile

Coastal Neurology Services

10 Members Way
Dover, NH 03820

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Monday - Friday: 8:00 a.m. - 5:00 p.m. 


Office: (603) 749-0913

Fax: (603) 749-0973

Wentworth-Douglass Hospital Outpatient Center

121 Corporate Drive (Building C)
Portsmouth, NH 03801

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Office: (603) 610-8075

Fax: (603) 610-8076

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