Brown Séquard syndrome: causes, symptoms and treatment

The spinal cord is one of the most important components of our body that we have; because thanks to it, our brain and the rest of our body communicate constantly.

Now what if he takes damage? One of the consequences of a spinal cord injury is Brown Séquard syndrome, Which we’ll be talking about throughout this article, along with its symptoms, causes, and possible treatments.

    What is Brown Séquard syndrome?

    Brown Sequard syndrome is a condition first described in 1849 by physiologist and neurologist Edouard Brown-Séquard; which is distinguished by the presentation of a series of very specific neurological symptoms caused by an injury to the spinal cord. More precisely, this lesion indicates a medullary hemisection which generally affects the lateral half.

    As a result, the person with Brown Séquard syndrome experiences muscle weakness, numbness and paralysis which can differ from person to person and loss of sensitivity in different areas of the body.

    These effects tend to occur in active motor function below the point in the spinal cord where the lesion is located. In addition, the area affected by the paralysis is also located on the same side where the spinal cord injury occurred.

    In order to better understand how this syndrome affects the person who suffers from it, it is first necessary to specify that the spinal cord is an essential component of the nervous system, which is responsible for collecting and transmitting sensory and motor information different areas of the body as well as the main brain nuclei. For this, it uses the nerves that are born along it.

    Therefore, if the person suffers a trauma, or undergoes the development of a tumor mass in the spinal cord which causes this hemisection, it is possible that then this Brown Séquard syndrome appears and leads to consequences such as these sensory alterations and pathologies linked to muscle fragility and paralysis.

    prevalence

    The incidence of Brown Séquard syndrome is quite low, for this reason, it is classified as a rare disease. Globally, there are only 30 to 40 cases of this disorder per million people. What’s more, research suggests that it affects more women than men; being the most affected age group between 16 and 30 years. However, the average age of patients with this syndrome is around 40 years.

    What are the symptoms?

    Although symptoms may differ from patient to patient Depending on the height of the spinal cord, symptoms will generally focus on three different categories: muscle weakness and paralysis, sensory perception and proprioception.

    1. Muscle weakness and paralysis

    Following the hemi-section of the spinal cord in Brown Séquard syndrome, the person tends to undergo significant alterations in their motor activities at the ipsilateral level. In other words, in one of the two halves of the body.

    The main motor symptoms associated with this syndrome are:

    • Hemiparesis or reduced mobility of half the body.
    • Hemiplegia o absolute paralysis of half the body.
    • Bladder problems and loss of bladder control.
    • Intestinal problems.
    • Muscular atrophy and weakening.
    • Problems in the ability to walk.
    • Functional dependence.

    2. Proprioception

    Proprioception is the sense in charge of informing our body of the position of our muscles. In other words, our position. Thanks to it, we can be aware and manage our automatic movements and reactions.

    When this sensation is affected, in this case by Brown Séquard syndrome, the person experiences an alteration in this bodily capacity.

    3. Sensory perception

    The main effects of Brown Séquard syndrome on sensory perception are the following symptoms:

    • Hypoalgesia or loss of sensitivity to contralateral pain in the affected area.
    • Hypoesthesia o decreased sensitivity.
    • Loss of sensitivity to temperature changes.
    • Ipsilateral loss of sensitivity to vibratory stimuli.

    What are the causes of this syndrome?

    Many factors can cause spinal cord damage. However, the most common cause that triggers Brown Séquard syndrome is traumatic injury to the spine or neck.

    Typically, these injuries are usually the result of broken bones or dislocations from a fall or blow or even some type of weapon injury. However, there are other causes related to the hospital environment. These refer to setback in surgery or for damage during removal of the cerebrospinal fluid drainage catheter.

    Regarding the causes or organic alterations that can cause this syndrome, let us quote:

    • Herniated discs.
    • Tumors.
    • Transverse myelitis.
    • Multiple sclerosis.

    • radiation.
    • Tuberculosis.
    • Epidural hematoma.
    • Drug use.
    • Bleeding.
    • Syphilis.
    • Herpes simplex.
    • Ischemia.
    • Ossifications.
    • Meningitis.

    Treatment and prognosis

    At the moment no specific treatment has been developed for Brown Séquard syndrome, So that the medical and health staff lead an individualized approach for each patient who suffers from it.

    However, there are a number of general or common guidelines that aim to keep the patient in a state of immobility in order to avoid further damage associated with a series of surgeries and repairs.

    On the other hand, the treatment too is accompanied by the administration of a number of analgesic drugs and corticosteroids to decrease the rest of Brown Séquard’s symptoms.

    Finally, these treatments are accompanied by physiotherapeutic rehabilitation which makes it possible to maintain the tone and strength of the muscles, as well as professional rehabilitation which gives the person back the functional independence lost during the disease.

    As for the prognosis of Brown’s syndrome, it is generally favorable at each start of treatment. As a rule more than 50% of patients tend to restore their motor capacity throughout the first year.

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