Zenodo
Neuromodulation for Refractory Neuropathic Pain Following Critical Illness: A Narrative Review and Phenotype-Based Clinical Framework
By Suresh Srinivasan, MD¹*, Kiran Khurshid MD2 , Uzam Hussain MD2 , Joseph Pathakamuri3, Mohanraj Palani Selvam MD3.
Abstract
Background
Persistent pain can complicate recovery after critical illness, but neuropathic pain remains incompletely characterized. Critical illness polyneuropathy, small-fiber injury, and focal peripheral nerve injuries may produce persistent pain alongside weakness, cognitive impairment, and psychological distress.
Objective
To critically synthesize the rationale and evidence for peripheral nerve stimulation (PNS), dorsal root ganglion stimulation (DRGS), and spinal cord stimulation (SCS) after critical illness and propose a framework for prospective evaluation.
Methods
This narrative review integrates critical-care survivorship literature, neurological diagnostic frameworks, selected neuromodulation trials and evidence syntheses, and procedural guidance. References were checked against accessible PubMed-indexed records and journal sources through October 4, 2026. Evidence concerning ICU survivors is distinguished from indirect evidence in analogous pain populations; no systematic-review or PRISMA-ScR compliance is claimed.