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Brown-Séquard syndrome

Disemak secara perubatan oleh Panel Perubatan Hello Doktor


Ditulis oleh English Content · Disemak pada 11/05/2020

Definition

What is Brown-Séquard syndrome?

Brown-Séquard syndrome is a spinal disorder that results from an injury to one side of the spinal cord in which the spinal cord is damaged but is not severed completely.

How common is Brown-Séquard syndrome?

Brown-Séquard syndrome is a rare disorder that affects males and females in equal numbers. More than 500 cases have been reported to date. The incidence of Brown-Séquard syndrome has been estimated to be 2% of all traumatic spinal cord injuries. The annual incidence of all forms of spinal cord injury is estimated to be 30-40 per 1,000,000 people. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of Brown-Séquard syndrome?

The common symptoms of Brown-Séquard syndrome are:

  • Sensory loss: the affected person loses the sense of touch, vibrations and/or position in three dimensions below the level of the injury (hemiparalysis or asymmetric paresis), particularly on the same side (ipsilateral) as the injury to the spine.
  • Loss of the sense of pain and of temperature (hypalgesia) on the side of the body opposite (contralateral) to the side at which the injury was sustained.
  • There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

    When should I see my doctor?

    If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

    Causes

    What causes Brown-Séquard syndrome?

    This syndrome is often a consequence of a traumatic injury by a knife or gunshot to the spine or neck. In many cases, however, it is caused by, or is the result of, other spinal disorders such as cervical spondylosis, arachnoid cyst or epidural hematomas. Brown-Séquard syndrome may also accompany bacterial or viral infections. Blunt traumas, such as occur in a fall or automobile accident, on rare occasions may be the cause of the Brown-Séquard syndrome.

    Risk factors

    What increases my risk for Brown-Séquard syndrome?

    Please discuss with your doctor for further information.

    Diagnosis & treatment

    The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

    How is Brown-Séquard syndrome diagnosed?

    Primarily, Brown-Séquard Syndrome is diagnosed by detecting motor paralysis on ipsilateral side of the injury and deficit in pain and temperature sensations on contralateral side of the injury. This observational diagnosis is followed by some image testing as given below:

    • For injuries in bones or in case of blunt trauma, Spinal plain radiograph helps to detect the affected spots precisely.
    • MRI scanning can detect the extent of the injury and MRI is particularly helpful when injuries are due to any non-traumatic causes.5
    • In traumatic causes of spinal cord injury, MRI is used when neurological conditions are deteriorating.
    • In case, MRI is contraindicating, CT myelography is used.

    In majority of situations, diagnosis of Brown-Séquard Syndrome is made on the basis of presenting history and scan reports. As most of the cases are caused by trauma, it is important to undertake differential diagnosis with respect to closely resembling diseases when there is no history of trauma. The differential diagnosis to be over-ruled for the diagnosis of this condition is:

    • Stroke
    • Tumors or cysts on spinal cord
    • Multiple sclerosis.
    • Spinal cord injury and compression.

    How is Brown-Séquard syndrome treated?

    At the start of treatment for Brown-Séquard syndrome, a systematic assessment, including neurological investigation, is performed to establish the level of injury. There is no specific treatment procedure available for Brown-Séquard syndrome. Treatment gives attention on the underlying cause of the syndrome. Some drugs are applied that control motor neuron disorders. Devices that help to continue day-to-day activities such as hand splits, limb supports, or a wheelchair are used whenever necessary for patients suffering from Brown-Séquard Syndrome. Various other aids for the patients with a difficulty in breathing or swallowing are also applied. Other treatment for Brown-Séquard syndrome is symptomatic and supportive like the following ones:

    • Cervical spine or dorsal spine mobilization is necessary, which is done through different therapies.
    • Neck is kept at rest with the help of cervical collar.

    Depending on the diagnosis, some surgical interventions may be needed. Such surgical interventions may improve prognosis to a great extent.

    It is known that partial spinal cord injury makes walking very problematic. Researchers these days are trying to estimate the consequence of treadmill speed on spinal cord function and walking performance.

    Lifestyle changes & home remedies

    What are some lifestyle changes or home remedies that can help me manage Brown-Séquard syndrome?

    The following lifestyles and home remedies might help you cope with Brown-Séquard syndrome:

    Devices that help an affected individual continue daily activities such as braces, hand splits, limb supports, or a wheelchair are important. Various other aids may be necessary if the patient has difficulty breathing or swallowing.

    If you have any questions, please consult with your doctor to better understand the best solution for you.

    Penafian

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    Ditulis oleh English Content · Disemak pada 11/05/2020

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