Brown-Sequard Syndrome
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Clinically Relevant Anatomy[edit | edit source]
Brown-Sequard Syndrome (BSS) is a neurological condition that results from a hemisection to the spinal cord[1]. It typically presents with paralysis on the side of the lesion and a loss of pain and temperature sensation contralateral to the lesion.
Mechanism of Injury / Pathological Process[edit | edit source]
The mechanism of injury in BSS can either be traumatic or non-traumatic with traumatic being more common[1].
Tramatic causes of BSS are as follows:
- Stab injury to the cervical region
- Gunshot wound to the spine
- Motor vehicular accident
- Fractured vertebra from a resultant fall
Non-traumatic mechanisms could include:
- Vertebral disc herniation
- Tumours
- Cervical spondylosis
- Multiple sclerosis
- Radiation
- Cystic disease[1]
Clinical Presentation[edit | edit source]
BSS is characterized by:
- Ipsilateral lower motor neuron paralysis in the segment of the lesion.
- Contralateral loss of pain and temperature sensations below the level of the lesion[2].
- Ipsilateral loss of tactile discrimination, vibratory and proprioceptive sensations below the level of the lesion.
- Contralateral partial loss of tactile sensation below the level of the lesion.
- Ipsilateral spastic paralysis below the level of the lesion.
Diagnostic Procedures[edit | edit source]
A detailed history should be taken to determine possible causes of the damage i.e. whether the lesion is traumatic or infectious. An extensive examination should be carried out to ascertain the extent of neurological damage and what deficits to expect, depending on the level of injury. This examination should involve a detailed motor and sensory evaluation.
Laboratory tests should be carried out when infections are suspected.
Outcome Measures[edit | edit source]
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Management / Interventions[edit | edit source]
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Differential Diagnosis[edit | edit source]
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Resources[edit | edit source]
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References[edit | edit source]
- ↑ 1.0 1.1 1.2 Shams S, Arain A. Brown Sequard Syndrome. [Updated 2020 Sep 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2021.
- ↑ Wright R, Simpson EP. Myelopathies. In: Rolak, AL editor. Neurology Secrets (Fifth Edition). Mosby 2010. p131-140.
