Peripheral Neuropathy and Nerve Compression Syndromes in Burns

Abstract

Peripheral neuropathy and nerve compression syndromes lead to substantial morbidity following burn injury. Patients present with pain, paresthesias, or weakness along a specific nerve distribution or experience generalized peripheral neuropathy. The symptoms may manifest at various times from within one week of hospitalization to many months after wound closure. While current treatments require surgical release of entrapped or compressed nerves, additional studies are necessary to develop therapies for peripheral neuropathy when no detectable signs of nerve compression are present. Studies have shown that peripheral neuropathy may also be due to vascular occlusion of vasa nervorum, inflammation, neurotoxin production leading to apoptosis, and direct destruction of nerves from the burn injury. A better understanding of the molecular and cellular mechanisms underlying the pathogenesis of neuropathic pain following burn injury is essential to the development of novel interventions. Early and effective treatment to minimize the long-term sequela of peripheral neuropathy and nerve compression syndromes will lead to improved outcomes. In this review, we discuss the natural history, diagnosis, current treatments, and future directions for potential interventions for peripheral neuropathy and nerve compression syndromes as they relate to burn injury.

Occupational Hand-Related Injuries at a Major Tertiary Care Burn and Reconstructive Center in Pakistan

“…This could be attributed to the early recognition of fracture on an X-ray or clinical examination. Fracture is more evident in the primary survey and hence rarely missed [22].…”

Spinal cord motor neuron plasticity accompanies second‐degree burn injury and chronic pain

“…Burn injury has been shown to contribute to several types of peripheral neuropathies associated with sensory dysfunction (Strong, Agarwal, Cederna, & Levi, ). Excessive peripheral nerve firing activity within scar tissue, peripheral nervous system (PNS) and CNS inflammation, loss of inhibitory regulation, and structural plasticity can contribute to chronic secondary complications associated with burn injury (Bijlard et al, ; Chang & Waxman, ; Guo et al, ; Shields et al, ).…”

Investigating the Prevalence of Peripheral Neuropathy in Chemical Burns

“…Peripheral neuropathy is not well documented or recognized in burn patients; hence, it is probably frequently missed or overlooked in clinical settings [2]. An association between peripheral neuropathy and burn incidents has been established, which is varied widely [2,3], for example, 2% to 84% of burn patients, depending on different methodologies. Helm et al assessed 66 burn patients and reported neuromuscular problems in 29% of burn patients [4], while Gabriel et al reported the prevalence of 5% (18/370) Moreover, peripheral neuropathy has a serious effect on rehabilitation [5].…”