From the Guidelines
Brown-Sequard syndrome is a spinal cord injury characterized by damage to one half of the spinal cord, resulting in ipsilateral loss of motor function, proprioception, and vibration sense, along with contralateral loss of pain and temperature sensation. This occurs because motor and proprioceptive pathways cross at the medulla, while pain and temperature pathways cross at the level of the spinal cord. Common causes include trauma, tumors, disc herniation, or inflammatory conditions. Other important spinal pathologies include:
- Complete spinal cord transection (causing total loss of motor and sensory function below the injury level)
- Central cord syndrome (affecting the central portion of the cord, particularly impairing upper extremity function)
- Anterior cord syndrome (damaging anterior spinal artery territory, causing motor deficits and loss of pain/temperature sensation while preserving proprioception)
- Posterior cord syndrome (affecting dorsal columns, causing loss of proprioception while preserving motor function)
- Cauda equina syndrome (compression of nerve roots below L1, causing bowel/bladder dysfunction, saddle anesthesia, and lower extremity weakness) 1. Treatment depends on the underlying cause but may include surgical decompression, corticosteroids for inflammation, rehabilitation, and management of complications. Early diagnosis and intervention are crucial for optimizing outcomes in all spinal cord pathologies. The provided studies on Guillain-Barré syndrome 1 do not directly relate to the diagnosis and management of Brown-Sequard syndrome and other spinal pathologies, but emphasize the importance of early diagnosis and intervention in neurological conditions.
From the Research
Spinal Pathologies
- Brown-Séquard syndrome is a type of incomplete spinal cord injury characterized by a lesion to one half of the spinal cord, resulting in paralysis and loss of proprioception on the same side as the injury, and loss of pain and temperature sensation on the opposite side 2, 3.
- Other types of spinal pathologies include central cord syndrome, which is a more common type of incomplete spinal cord injury compared to Brown-Séquard syndrome 4.
- Spinal cord hemisection, which can result in Brown-Séquard syndrome, can be caused by various factors such as penetrating injuries, cervical disc herniation, and stab injuries 3, 5.
Characteristics of Brown-Séquard Syndrome
- Ipsilateral paralysis and loss of proprioception 2, 3
- Contralesional loss of pain and temperature sensation 2, 3
- Variable recovery of motor function, with some cases showing significant improvement and others showing limited recovery 3, 4, 5
- Differential recovery of forelimb and hindlimb locomotion, with hindlimb locomotion showing better recovery than forelimb locomotion 6