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BROWN-SEQUARD SYNDROME

Neurosurgery

BROWN-SEQUARD SYNDROME

1. Hemisection of the spinal cord.
2. At the level of the lesion = ipsilateral loss of all sensation + LMN paralysis. Below the level of the lesion = ipsilateral loss of vibration + proprioception, contralateral loss of pain + temperature, ipsilateral UMN paralysis.
3. Explained by crossing of the spinothalamic fibers, whereas the dorsal column and corticospinal fibers cross in the brainstem.
4. Brown-Sequard plus syndrome = relative ipsilateral hemiplegia + relative contralateral hemi-anaesthesia.
5. Recovery - motor recovery before opposite sensory recovery, ipsilateral proximal extensors then distal flexors.
6. 75-90% are ambulant by discharge, 70% are imdependent in functional activity.
7. If UL is weaker than LL - best prognosis for ambulation + bowel and bladder recovery.


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REFERENCES

1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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