From the Research
The clinical presentation of Brown-Séquard syndrome, also known as Hemicord (half of the spinal cord) syndrome, is characterized by ipsilateral loss of motor function, proprioception, and vibration sense, along with contralateral loss of pain and temperature sensation, due to damage to the corticospinal tract, dorsal columns, and spinothalamic tract on one side of the spinal cord. This condition results from hemisection of the spinal cord, which can be caused by various factors such as traumatic injuries, metastatic compression, or other space-occupying lesions. The clinical presentation demonstrates a classic pattern with weakness and loss of proprioception and vibration sense on the same side as the lesion, and loss of pain and temperature sensation on the opposite side, consistent with a hemisection of the spinal cord at a specific level 1.
Key Features of Brown-Séquard Syndrome
- Ipsilateral loss of motor function due to damage to the corticospinal tract
- Ipsilateral loss of proprioception and vibration sense due to damage to the dorsal columns
- Contralateral loss of pain and temperature sensation due to damage to the spinothalamic tract
- The level of the lesion determines the level of the neurological deficits
Diagnosis and Management
The diagnosis of Brown-Séquard syndrome is based on a thorough clinical assessment, including a detailed neurological examination and imaging studies such as MRI to confirm the presence of a hemisection of the spinal cord. Management of the condition depends on the underlying cause, and may involve surgical intervention to relieve compression on the spinal cord, as well as rehabilitation and physical therapy to optimize functional recovery 1.
Prognosis
The prognosis for Brown-Séquard syndrome varies depending on the severity of the injury and the level of the lesion. In general, the majority of recovery is observed during the initial 9-12 months, with a relative plateau reached by 12-18 months post-injury 2. Prompt recognition and management of the condition are essential to optimize outcomes and minimize long-term disability.