What are the Symptoms of Small fiber peripheral neuropathy? Small fiber peripheral neuropathy manifests in two main types of symptoms: positive and negative. Positive symptoms involve exaggerated sensations, such as burning, typically starting at the feet and moving upward, eventually affecting the hands. These are associated with small fibers or C fibers, which sense pain and temperature. Negative symptoms, often the first to appear, involve loss of sensations like a pinprick or temperature det