What causes Brown-Séquard syndrome?

From the Research

Brown Sequard syndrome is caused by damage to one half (hemisection) of the spinal cord, resulting in a characteristic pattern of neurological deficits, with the most common causes including traumatic injuries such as stab wounds, gunshot wounds, or fractured vertebrae that compress one side of the spinal cord, as reported in a case study published in 2020 1. The syndrome produces a distinctive clinical picture with ipsilateral (same side) loss of motor function, proprioception, and vibration sense below the level of injury, combined with contralateral (opposite side) loss of pain and temperature sensation. Some key points to consider include:

• The role of surgery in the treatment of penetrating spinal injury often remains controversial, as discussed in a study published in 2014 2.
• The recovery of neurological function depends on the type and severity of the spinal cord damage, with indications for acute surgical management being limited and conservative management often preferred, as noted in a study published in 2014 2.
• Other causes of Brown Sequard syndrome include spinal cord tumors, herniated discs, spinal cord infarction (stroke), multiple sclerosis, and infectious processes like epidural abscesses or tuberculosis affecting one side of the spinal cord.
• The use of distal nerve transfer for improving upper limb function has been described for patients with tetraplegic spinal cord injury and brachial plexus injuries, and has also been used in patients with Brown-Séquard type spinal cord injury, as reported in a case study published in 2018 3. Some important considerations in the diagnosis and treatment of Brown Sequard syndrome include:
• The importance of early diagnosis and treatment to improve outcomes, as noted in a study published in 2020 1.
• The need for a multidisciplinary approach to care, including physical therapy, occupational therapy, and pain management, as discussed in a study published in 2021 4.
• The potential for nerve transfers to improve upper limb function in patients with Brown-Séquard type spinal cord injury, as reported in a case study published in 2018 3.