Brown Sequard Syndrome: Causes, Symptoms, and Treatment

The spinal cord is one of the most important components of our body that we have; since thanks to it our brain and the rest of our body are constantly in communication.

Now, what happens if it suffers some damage? One of the consequences of a spinal cord injury is Brown Sequard syndrome., which we will talk about throughout this article, as well as its symptoms, causes and possible treatments.

• Related article: "The 15 most common nervous system diseases"

What is Brown Sequard syndrome?

Brown Sequard syndrome is a condition first described in 1849 by the physiologist and neurologist Edouard Brown-Sequard; which is distinguished by presenting a series of very specific neurological symptoms caused by a lesion in the spinal cord. Specifically, this lesion refers to a medullary hemisection that, as a general rule, damages the lateral half.

As a consequence, the person suffering from Brown Sequard syndrome experiences muscle weakness, numbness, and paralysis which can differ from one person to another and the loss of sensation in different parts of the body.

These effects tend to occur in active motor function below the point of 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 damage has occurred.

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

Therefore, if the person suffers trauma, or experiences the development of a tumor mass in the spinal cord that causes this hemisection, it is possible that then this Brown Sequard syndrome appears and entails consequences such as these sensory alterations and pathologies associated with fragility and paralysis muscular.

prevalence

The incidence of Brown Sequard syndrome is quite low, hence it is categorized as a rare disease. Worldwide there are only between 30 and 40 cases of this disorder for every million people. In addition, research indicates that it affects a greater number of women than men; The most affected age group being between 16 and 30 years. However, the average age of patients suffering from this syndrome is approximately 40 years.

What symptoms does it present?

Despite symptoms may differ from patient to patient Depending on how high up in the spinal cord the lesion is, symptoms are usually focus on three distinct categories: muscle weakness and paralysis, sensory perception, and proprioception.

1. Muscle weakness and paralysis

As a consequence of the medullary hemisection typical of Brown Sequard syndrome, the person tends to experience major disturbances in motor activities at the ipsilateral level. That is, in one of the two halves of the body.

The main motor symptoms associated with this syndrome are:

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

2. proprioception

Proprioception is the sense that is responsible for inform our body of the position of our muscles. That is, from our position. Thanks to it we can be aware and manage our movements and automatic reactions.

When this sense is affected, in this case by Brown Sequard syndrome, the person experiences an impairment of this bodily capacity.

3. sensory perception

The main effects of Brown Sequard syndrome on sensory perception capacity are specified in the following symptoms:

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

What are the causes of this syndrome?

There are a large number of factors that can cause a spinal cord injury. However, the most common cause that triggers Brown Sequard syndrome is a traumatic injury to the spine or neck.

As a general rule, these injuries are usually the result of fractures or dislocations from a fall or blow, or even from some type of weapon injury. However, there are other causes related to the hospital environment. These refer to setbacks in surgery or from damage when removing the cerebrospinal fluid drainage catheter.

As for the causes or organic alterations that can cause this syndrome, they include:

• Herniated discs.
• Tumors.
• Transverse myelitis.
• Multiple sclerosis.
• Radiation.
• Tuberculosis.
• epidural hematoma.
• Consumption of drugs.
• hemorrhages.
• Syphilis.
• Herpes simplex.
• Ischemias.
• ossifications.
• Meningitis.

Treatment and prognosis

For now No specific treatment has been developed for Brown Sequard syndrome.Therefore, the medical and health personnel carry out an individualized approach for each patient who suffers from it.

However, there are a series of general or common guidelines that consist of keeping the patient in a state of of immobility in order to prevent further damage together with a series of interventions and repairs surgical.

On the other hand, the treatment is accompanied by the administration of a series of analgesic drugs and corticosteroids to reduce the rest of the symptoms of Brown Sequard.

Finally, these treatments are accompanied by a physiotherapeutic rehabilitation that allows sustaining the tone and strength of the muscles, as well as an occupational rehabilitation that restores the person's functional independence lost during the course of the disease.

As for the prognosis of Brown syndrome, this is usually favorable as long as treatment is started. As a rule more than 50% of patients tend to restore their motor capacity throughout the first year.