From the Research
Brown-Séquard syndrome is characterized by ipsilateral loss of motor function, proprioception, and vibration sense, with contralateral loss of pain and temperature sensation, due to damage to one lateral half of the spinal cord. This condition results from a hemisection of the spinal cord, which can be caused by various factors such as trauma, tumors, or myelitis. The clinical features of Brown-Séquard syndrome include:
- Ipsilateral loss of motor function below the level of injury
- Ipsilateral loss of proprioception and vibration sense below the level of injury
- Contralateral loss of pain and temperature sensation below the level of injury
- Ipsilateral hyperreflexia and a positive Babinski sign due to upper motor neuron damage
The anatomical basis for these findings is due to the damage to specific tracts in the spinal cord, including the corticospinal tract, posterior columns, and spinothalamic tract 1. The spinothalamic tract fibers cross to the contralateral side shortly after entering the spinal cord, resulting in contralateral loss of pain and temperature sensation. In contrast, the dorsal column-medial lemniscus pathway and corticospinal tracts cross higher in the medulla, resulting in ipsilateral loss of motor function and proprioception.
Recent studies have reported cases of Brown-Séquard syndrome due to various causes, including penetrating spinal cord injuries 2 and idiopathic myelitis 3. These cases highlight the importance of considering Brown-Séquard syndrome in the differential diagnosis of patients presenting with neurological deficits. The diagnosis and treatment of Brown-Séquard syndrome depend on the underlying cause and severity of the spinal cord damage, and may involve surgical or conservative management 2.
The most recent and highest quality study on Brown-Séquard syndrome was published in 2021, which reported two cases of idiopathic myelitis presenting as Brown-Séquard syndrome 3. This study highlights the importance of considering myelitis as a potential cause of Brown-Séquard syndrome, and emphasizes the need for a thorough diagnostic workup to determine the underlying cause of the condition.
In terms of morbidity, mortality, and quality of life, Brown-Séquard syndrome can have significant implications for patients, including permanent neurological deficits and disability. Therefore, prompt and accurate diagnosis, as well as appropriate treatment, are essential to optimize outcomes and improve quality of life for patients with this condition.