Brown-Sequard syndrome

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Brown-Sequard syndrome Classification and external resources
Brown-Sequard syndrome is bottom diagram
ICD-10	G83.8
ICD-9	344.89
DiseasesDB	31117
eMedicine	emerg/70  pmr/17
MeSH	D018437

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Brown-Séquard syndrome, also known as Brown-Séquard's hemiplegia and Brown-Séquard's paralysis, is a loss of motricity (paralysis and ataxia) and sensation caused by the lateral hemisection of the spinal cord. Other synonyms are crossed hemiplegia, hemiparaplegic syndrome, hemiplegia et hemiparaplegia spinalis and spinal hemiparaplegia.

Effects

The hemisection of the cord results in a lesion of each of the three main neural systems:

• the principal upper motor neuron pathway of the corticospinal tract
• one or both dorsal columns
• the spinothalamic tract

As a result of the injury to these three main brain pathways the patient will present with three lesions.

• The corticospinal lesion produces spastic paralysis on the same side of the body (the loss of moderation by the UMN).

• The lesion to fasciculus gracilis or fasciculus cuneus results in ipsilateral loss of vibration and proprioception (position sense).

• The loss of the spinothalamic tract leads to pain and temperature sensation being lost from the contralateral side beginning one or two segments below the lesion. At the lesion site all sensory modalities are lost on the same side, and also an ipsilateral flaccid paralysis.

Causes

[Brown-Sequard syndrome][3] may be caused by a spinal cord tumor, trauma (such as a gunshot wound or puncture wound to the neck or back), ischemia (obstruction of a blood vessel), or infectious or inflammatory diseases such as tuberculosis, or multiple sclerosis.

History

It was first described in 1850 by the historically famous British neurologist Charles Édouard Brown-Sequard (1817-1896), who studied the anatomy and physiology of the spinal cord. ^[1][1] Brown-Sequard was quite a controversial and eccentric figure, and is also known for self-reporting "rejuvinated sexual prowess after eating extracts of monkey testis". The response is now thought to have been a placebo effect, but apparently this was "sufficient to set the field of endocrinology off and running."^[1]

Interestingly, many nations claim him as their own, he was the son of an American sea captain and a French woman, living in a British territory. He studied in the US, France, as well as the UK. He described this injury which resulted from caning knives trauma in Mauritius.

References

External links

• Image at ufl.edu

v • d • e Lesions of spinal cord, brainstem, and cortex
Spinal cord	Anterior cord syndrome - Brown-Séquard syndrome - Central cord syndrome
Medulla (CN 8, 9, 10, 12)	Lateral medullary syndrome/Wallenberg (PICA) - Medial medullary syndrome (ASA)
Pons (CN 5, 6, 7, 8)	Lateral pontine syndrome (AICA) - Medial pontine syndrome (Basilar) - Locked-In syndrome (ventral)
Midbrain (CN 3, 4)	Weber's syndrome (medial, PCA) - Parinaud's syndrome (dorsal)
Cortex	Anterior cerebral artery syndrome - Middle cerebral artery syndrome - Posterior cerebral artery syndrome

de:Brown-Séquard-Syndrom

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Acknowledgement and Attribution Regarding Sources of Content

Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .