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.
