Introduction
Brown-Sequard syndrome, or hemi-section of the spinal cord, occurs due to partial damage to the spinal cord. This damage can be caused by various factors, including:
- Fracture or dislocation of the vertebral column
- Bullet or stab wounds
- Expanding tumors
Characteristics
Once the initial period of spinal shock subsides, individuals with complete hemisection of the spinal cord typically present with distinct neurological symptoms, affecting both the same side (ipsilateral) and opposite side (contralateral) of the body from the spinal cord lesion. These symptoms include:
Ipsilateral Effects (Same Side as Lesion):
- Lower Motor Neuron Paralysis: Paralysis and muscle atrophy occur at the same level as the spinal cord injury.
- Upper Motor Neuron Paralysis: Paralysis develops below the level of the lesion due to damage to the corticospinal tract.
- Cutaneous Anesthesia: Loss of sensation in a band-like distribution at the level of the lesion.
- Loss of Tactile Discrimination, Vibration, and Proprioception: Impaired ability to sense fine touch, vibration, and body position below the lesion due to damage to the ascending tracts in the posterior white column.
Contralateral Effects (Opposite Side of Lesion):
- Loss of Pain and Temperature Sensation: Inability to feel pain and temperature below the lesion level. This occurs due to damage to the lateral spinothalamic tract, which crosses over to the opposite side of the spinal cord shortly after entering. Notably, the oblique crossing of this tract results in sensory loss beginning a few segments below the actual lesion.
- Partial Loss of Tactile Sensation: Some reduction in the ability to feel light touch below the lesion level, attributed to damage to the anterior spinothalamic tracts.
