Brown-Sequard Syndrome
What is Brown-Sequard Syndrome (BSS)?
Brown-Sequard syndrome (BSS) is a rare neurological condition characterized by a lesion in the spinal cord which results in weakness or paralysis (hemiparaplegia) on one side of the body and a loss of sensation (hemianesthesia) on the opposite side.
BSS may be caused by a spinal cord tumor, trauma (such as a puncture wound to the neck or back), ischemia (obstruction of a blood vessel), or infectious or inflammatory diseases such as tuberculosis, or multiple sclerosis.
What are the symptoms of Brown-Sequard Syndrome (BSS)?
Symptoms of Brown-Séquard syndrome usually appear after an affected individual experiences a trauma to the neck or back.
First symptoms are usually loss of the sensations of pain and temperature, often below the area of the trauma. There may also be loss of bladder and bowel control. Weakness and degeneration (atrophy) of muscles in the affected area may occur. Paralysis on the same side as that of the wound often occurs. Paralysis may be permanent if diagnosis is delayed. Individuals with this syndrome have a good chance of recovering a large measure of function. More than 90% of affected individuals recover bladder and bowel control, and the ability to walk.
Most affected individuals regain some strength in their legs and most will regain functional walking ability.
What causes Brown-Sequard Syndrome (BSS)?
BSS 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.
What are the treatments for Brown-Sequard Syndrome (BSS)?
Treatment for individuals with BSS focuses mainly on the underlying cause of the disorder. Early treatment with high-dose steroids may be beneficial in many cases.
Physical, occupational and recreational therapy are important aspects of patient rehabilitation. Other treatment is symptomatic and supportive.
