Brown-Sequard Syndrome Symptoms

Brown-Sequard syndrome symptoms vary in severity, affecting each side of the body differently.

Ipsilateral side symptoms:

• Paralysis and a loss of motor function below the level of the lesion. The exact level of this depends on the site of the injury - a lesion high on the spinal cord will affect all four limbs, whereas an injury lower on the spinal cord will only affect the lower body.
• Loss of ability to feel vibrations and a light touch.
• Loss of ability to tell where the touch has occurred - the patient may know they have been touched, but be unable to distinguish exactly where.
• An abnormal plantar reflex - when the foot is stroked firmly, the plantar reflex should cause the foot to flex downwards. One of the Brown-Séquard Syndrome symptoms is an upward flex (known as the Babinski sign), indicating that the spinal cord is damaged.

Contralateral side:

The effects of the lesion on the contralateral side are evident from one or two segments below the level of the injury. Symptoms include:

• Loss of ability to sense pain
• Inability to sense temperature
• Inability to detect crude touch
• Lack of plantar reflex - this is caused by the loss of pain sensation. Stimulation of the foot does not provoke a response.

How are the symptoms treated?

Naturally, the treatment of Brown-Sequard Syndrome symptoms varies, depending on the cause of the damage to the spinal cord. If the injury is caused by a trauma, the damage may be permanent, and so the symptoms are also likely to be permanent. However, if the lesion is caused by a temporary problem, such as a cyst pressing on the spinal column, the removal of the cause may help the symptoms to improve.

Brown-Sequard Syndrome is caused by a lateral injury to the spinal cord, and named after physiologist Charles-Édouard Brown-Sequard, who first identified the condition in 1850. The spinal cord may be fully severed, or partially severed causing 'partial Brown-Sequard' or 'incomplete Brown-Sequard'.

What causes Brown-Sequard Syndrome?

There are a number of ways in which the spinal cord can be damaged causing Brown-Séquard Syndrome. These include:

• Accidental damage - e.g. may be caused by a stabbing or gunshot wound
• A tumour or cyst causing damage to the spinal cord
• An infection or inflammatory disease such as TB, meningitis, and some STDs
• A degenerative condition e.g. a prolapsed disc
• A vascular problem e.g. a haemorrhage

What damage is caused?

In Brown-Sequard Syndrome the spinal cord suffers an injury or lesion. Three major groups of nerves cross at the spinal cord, so damage here affects many functions. Because each side of the cord contains different nerves, each side of the body is affected differently.

The injured side (ipsilateral)

The dorsal column-medial lemniscus tract carries the nerves related to recognising a light touch, discerning different areas of the body, sensing vibration and pressure and the ability to sense two objects touching the skin that are close to each other.

Damage to the corticospinal tract affects the motor control nerves.

The opposite side (contralateral)

The spinothelamic tract houses nerves that sense pain, temperature and crude touch.