Brownsequard syndrome is a rare presentation of cervical disc herniation but accurate diagnosis, and early anterior spinal cord decompression lead. Brownsequard syndrome bss is a wellknown entity that is most commonly caused by a penetrating injury to the spinal cord e. This article also presents the unusual phenomena of brownsequard syndrome and unilateral horners syndrome after blunt traumatic injury to the cervical spine. Brown sequard syndrome an overview sciencedirect topics. Brownsequard syndrome is an incomplete spinal cord lesion characterized by a clinical picture reflecting hemisection injury of the spinal cord. Brown sequard syndrome hemisection of the spinal cord caused by extramedullary lesions usually caused by penetrating trauma or tumour. Brownsequard syndrome after blunt cervical spine trauma. Pdf on feb 1, 2018, eliza moskowitz and others published brownsequard syndrome find, read and cite all the research you need on researchgate. This phenomenon was first described by charles edouard brownsequard in 1850, who described what is now known as brownsequard syndrome when studying farmers injured while cutting sugar cane in the republic of mauritius. A cta done in the er also showed splenic and renal infarcts and a. Brownsequard syndrome is caused by damage to one half of the spinal cord, i.
Brownsequard syndrome from cervical disc herniation, a case. Brown sequard syndrome, occurring frequently in spinal cord injuries, rarely is caused by degenerative processes, such as cervical herniated discs. Brownsequard syndromesymptomscausestreatmentprognosis. The incidence of brownsequard syndrome has been estimated to be 2% of all traumatic spinal cord injuries. This article reports a case of brown sequard syndrome that occurred in a patient following the administration of trivalent influenza vaccine. Brownsequard syndrome, also known as hemicord syndrome, is the result of damage to, or impairment of, the left or right side of the spinal cord. Ipsilateral loss of proprioception due to posterior column involvement. Neurologic examination demonstrated 05 right triceps and grip strength to the right upper extremity and 05 motor strength throughout the entire. The physical signs of classic brownseuard syndrome are shown in figure 2. Charles edouard brownsequard, 18171894, mauritian physician.
Rehabilitation of a patient with symptoms of brown. Bss may be caused by a spinal cord tumor, trauma such as a puncture wound to the neck or back. The motor nerves that send axons down from the brain are also affected in brownsequard syndrome. Pdf management of brownsequard syndrome in cervical disc. Incomplete spinal cord syndromes knowledge for medical. Cause lateral damage to one side of the cord may be caused by penetration injuries such as stab wounds but may also result from other etiologies and injury mechanisms such as road traffic. Injury to half the spinal cord, or hemisection of the cord, can occur with trauma, tumor, or disc herniation.
We present the case of a 51 year old male patient, who presented with the sudden start of a clinical picture of brownsequard syndrome, with right hemiplegia, absence of right proprioception and. There are several causes of brown sequard syndrome, including. Brownsequard syndrome definition of brownsequard syndrome. But most often it is seen in textbooks and in med school exams. Brown sequard syndrome results from a transverse hemisection of the spinal cord, whereby half of the spinal cord is damaged laterally sullivan 1989. It causes paralysis, loss of vibration sensation, and loss of proprioceptive input ipsilaterally, with contralateral loss of pain and. We present the case of a 51 year old male patient, who presented with the sudden start of a clinical picture of brown sequard syndrome, with right hemiplegia, absence of right proprioception and. It is possible for edema, or swelling, to cause stress to the nerves. Brownsequard syndrome is a rare disorder that affects males and females in equal numbers.
It is characterized by an ipsilateral weakness damage to corticospinal tracts and contralateral loss of pain and temperature two levels below the lesion damage to lateral spinothalamic tracts. A 17yearold man presents to the emergency department after a physical altercation that resulted in a stab wound. The salient features of the reported cases are summarized with our patient and listed in table 1. Brownsequard syndrome brownsequard syndrome usually follows spinal cord hemisection as a result of penetrating trauma, but can also occur with large disc herniation or spinal epidural hematoma. Ipsilateral flaccid paralysis at the level of the lesion.
Brown sequard syndrome nord national organization for rare. Brownsequard syndrome bss consists of asymmetric paresis with hypalgesia more marked on the less paretic side. She did not have any trauma or other symptoms that would have caused compartment syndrome. The spinothalamic tracts enter the cord and travel ipsilaterally for one to two levels before crossing over, and, therefore, the contralateral loss of. It was first described in the 1840s by dr charlesedouard brownsequard 181794. The annual incidence of all forms of spinal cord injury is estimated to be 3040 per 1,000,000 people. There are several causes of brownsequard syndrome, including.
Brownsequard syndrome can be incomplete and temporary. Symptoms include weaknessparalysis hemiparaplegia to one side of the body and a loss of sensation hemianesthesia to the opposite side of the body. The most common cause of this syndrome remains traumatic injury to just part of the back. Browns e quard syndrome bss, also known as hemisection of the spinal cord or partial spinal sensory syndrome, is a rare condition caused by an incomplete lesion of the spinal cord. Know the causes, symptoms, treatment, prognosis, pathophysiology and diagnosis of brownsequard syndrome. Brown sequard syndrome bss is a wellknown entity that is most commonly caused by a penetrating injury to the spinal cord e. Brownsequard syndrome is a rare condition that results from an injury to one side of the spinal cord.
Apr 06, 2018 brownsequard syndrome is a disorder due to incomplete spinal cord lesion where one half of the body may lose normal ability or may be paralyzed while the other half of the body loses its normal sensation. However, partial hemisection is evident, and it often includes all the nerve tracts lying along the path in the injured area involved. There is an ipsilateral loss of motor control since the motor information decussates higher at the level of the brainstem. Famous victorian scientist, charlesedouard brownsequard, explained a rare spinal cord injury known as brownsequards syndrome bss. Brownsequard is credited with the description of the classic syndrome of ipsilateral hemiplegia and loss of proprioceptive sensation with contralateral loss of pain and temperature sensations following a spinal hemisection. Brownsequard syndrome brownsequards syndrom svensk definition. Neuromyelitis optica spectrum disorder presenting as brown. Brownsequard moved to paris intending to become a writer but, after his manuscripts were repeatedly rejected, he became a medical student. Charlesedouard brownsequard frs 8 april 1817 2 april 1894 was a mauritian physiologist and neurologist who, in 1850, became the first to describe what is now called brownsequard syndrome. The official patients sourcebook on brownsequard syndrome. Neurologic examination demonstrated 05 right triceps and grip strength to the right upper extremity and 05 motor strength throughout the.
Pdf on feb 1, 2018, eliza moskowitz and others published brownsequard syndrome find, read and cite all the research you need on. The classic description involves a dissociated sensory loss with contralateral loss of pain and temperature but preserved ipsilateral light touch and. A case of brownsequard syndrome with associated horners. Brownsequard syndrome as a first presentation of multiple sclerosis. Brownsequard syndrome information page national institute. Brownsequard syndrome is a characteristic spinal cord lesion that usually results from lateral hemisection of the cord. Ipsilateral loss of all sensory modalities at the level of the lesion.
If the lesion is involved in the cervical region, for example, c5 to t1, that hemisection would create deficits in the following manner. Brown sequard syndrome can be incomplete and temporary. Although often not as prominent clinically, ipsilateral vibration and proprioceptive loss also occurs on the same side as the motor symptoms. Nov 24, 2014 brownsequards syndrome results from a lesion in one lateral half of the spinal cord for example, hemisection or lateral injury of the cord. This article also presents the unusual phenomena of brown sequard syndrome and unilateral horners syndrome after blunt traumatic injury to the cervical spine. Brownsequard syndrome from cervical disc herniation, a. This damage, most often from physical trauma, results in a contralateral opposite side of the body loss of sensation and temperature and ipsilateral same side. This syndrome involves injury to only 1 side of spinal cord. Traumatic brownsequardplus syndrome emergency medicine.
This must include a thorough examination of the central and peripheral nervous system where spinal injury is suspected, even in the absence of radiographic abnormality and neck pain. A rare case of brownsequard syndrome caused by traumatic. The points to note are total loss of sensation and flaccid paralysis at the level of the lesion due to destruction of nerve fibres at that segment of the spinal cord. Brownsequardplus syndrome with features of autonomic dysreflexia and horners syndrome caused by blunt trauma. Central cord syndrome, anterior cord syndrome, posterior cord syndrome, and brownsequard syndrome are the most common types of incomplete spinal cord syndromes.
Brownsequard syndrome, occurring frequently in spinal cord injuries, rarely is caused by degenerative processes, such as cervical herniated discs. Contralateral loss of pain and temperature due to involvement of lateral spinothalamic tract. Brownsequard syndrome bss is a rare neurological condition characterized by a lesion in the spinal cord which results in weakness or paralysis hemiparaplegia on one side of the body and a loss of sensation hemianesthesia on the opposite side. In recent years the name of brownsequard has been assigned to syndromes caused by spinal cord damage differing widely in extension. The patient responded well to intravenous steroids and physical therapy. Postvaccinial influenza disseminated encephalopathy. Rehabilitation of a patient with symptoms of brown sequardplus syndrome after removal of a benign thoracic tumor. Keep in the program office or library for use by students, faculty, or staff.
The association between brownsequard syndrome and herniated cervical disc is rarely reported in the medical literature. Brownsequard syndrome bss is a type of incomplete spinal cord lesion with a particular clinical pattern, which is characterized by the paralysis and loss of proprioception on the body side of the injury ipsilateral and loss of pain and temperature sensation on the opposite one. This article reports a case of brownsequard syndrome that occurred in a patient following the administration of trivalent influenza vaccine. Place in the sage colleges library collection and reproduce for interlibrary loan. The injury produces a unique constellation of findings. Brownsequard syndrome most commonly occurs in the the thoracic spine upper and middle back. The anatomy of motor and sensory nerves and spinal pathways brownsequard and his syndrome robert tattersall, benjamin turner. Apr 27, 2018 the motor nerves that send axons down from the brain are also affected in brown sequard syndrome. Feb 01, 2017 brown sequard syndrome most commonly occurs in the the thoracic spine upper and middle back. Brown sequard syndrome is a rare condition that results from an injury to one side of the spinal cord. It is characterized by a characteristic pattern of motor and sensory deficits that are determined by the decussation pattern of various white matter tracts. Rehabilitation of a patient with symptoms of brown sequard. A 67yearold otherwise healthy woman was assaulted with a knife, receiving multiple stab wounds.
Part i explores basic techniques to researching brown sequard syndrome e. Brownsequardplus syndrome with features of autonomic. Brownsequard syndrome also known as brownsequards hemiplegia, brownsequards paralysis, hemiparaplegic syndrome, hemiplegia et hemiparaplegia spinalis, or spinal hemiparaplegia is caused by damage to one half of the spinal cord, i. First described in 1850, it is characterized by ipsilateral weakness damage to corticospinal tracts and contralateral loss of pain and temperature e. This is the report of a 63yearold woman presenting with brownsequard syndrome due to spontaneous extradural c56 cervical disc herniation. He qualified in 1846 by defending his thesis on physiology of the spinal cord. Cardiovascular responses to static exercise in patients with brownsequard syndrome. Part i explores basic techniques to researching brownsequard syndrome e. The association between brown sequard syndrome and herniated cervical disc is rarely reported in the medical literature. Jun 09, 2019 with brown sequard syndrome, a cleancut hemisection is usually not visible. Understanding brownsequard syndrome verywell health. With brownsequard syndrome, a cleancut hemisection is usually not visible. Syndrom associerat med halvsidig ryggmargsskada, med foljande kliniska kannetecken belagna under skadestallet. Brownsequard syndrome a neurological disorder, caused by compression of one side of the spinal cord in the lower back, featuring paralysis on the injured side and loss of sensation on the other side.
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