CORD SYNDROME-BROWN SEQUARD SYNDROME

SUMMARY

1. Hemisection of the spinal cord.

2. Below the level of the lesion: ipsilateral loss of vibration & proprioception; contralateral loss of pain & temperature; ipsilateral UMN paralysis.
- At the level of the lesion: ipsilateral loss of all sensation & LMN 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-anesthesia.

5. Recovery: motor recovery before opposite sensory recovery, ipsilateral proximal extensors then distal flexors.

6. 75-90% are ambulant by discharge, 70% are independent in functional activity.

7. If UL is weaker than LL: best prognosis for ambulation, bowel & bladder recovery.

Reference(s)

Cifu, D.X. (2020). Braddom’s physical medicine and rehabilitation. Elsevier. Get it on Amazon.
Cuccurullo, S. (2019). Physical medicine and rehabilitation board review. New York: Demosmedical. Get it on Amazon.
O’Young, B., Young, M.A. and Stiens, S.A. (2008). Physical Medicine and Rehabilitation Secrets. Mosby. Get it on Amazon.