Brown-Sequard syndrome entails an incomplete spinal cord lesion that is shown as a hemisection injury of the spinal cord in the cervical cord region. The patients with this condition suffer from ipsilateral upper motor neuron paralysis as well as loss of proprioception and can also experience loss of pain and temperature sensation. The condition is rare, but for the people who experience it is as a result of damage to one part of the spinal cord leading to paralysis and loss of sensation.
The common causes include a tumor at the spinal cord, trauma in the form of a gunshot wound to the neck or thorax, ischemia or the inflammatory diseases such as tuberculosis (Lockhart & Davis, 2015). The syndrome is not permanent, and its progression depends on the extent of the original spinal cord injury and the pathology that led to it. It can be due to neoplasia involving spinal cord tumor or vascular causes in the form of hemorrhage. Infectious causes of brown sequard syndrome include meningitis, empyema, herpes zoster virus, and herpes simplex virus which predispose a body to the condition.
Epidemiology
Brown-Sequard syndrome is rare, and the true incidence remains unclear. The incidence of traumatic spinal cord injuries in U.S has estimated at 12,000 new cases annually, and only about 2-4% of the cases are due to injuries. The prevalence in U.S is estimated at 273,000 persons, but the international incidence is unknown (McKinley, Santos, Meade & Brooke, 2007). Various demographic studies have shown great frequency of the spinal cord injuries in males as compared to females.
Classification
The classification of the syndrome is based on the motor and sensory findings that are classified based on the American Spinal Injury Association (ASIA) standard neurologic classification of spinal cord injury. The neurologic level is considered as the most critical segment with normal functioning, and the complete and incomplete assessment is based on the sensory or motor functioning. The ASIA Impairment Scale shows the level of incomplete injury by the motor and sensory functioning beneath the neurologic level.
Pathophysiology and diagnosis
The syndromes cause a lesion at each of the neural systems including the principal upper motor neuron, one or both dorsal columns, and the spinothalamic tract. The injury of the three main pathways of the brain makes a patient has three lesions. The corticospinal lesion produces spastic paralysis on the same part of the body below the lesion and at the level of the lesion; there is flaccid paralysis of the muscles that are supplied by the nerve. The lesion to the fasciculus gracilis results to ipsilateral loss of vibration and sense of position and all the sense of fine touch.
Carolyn Morgan is the author of this paper. A senior editor at MeldaResearch.Com in professional academic writing services.
