Brown Sequard syndrome: causes, symptoms, and treatment
The spinal cord is one of the most important components of our body that we have; since thanks to it our brain and the rest of our body are constantly communicated.
Now, what happens if it suffers some damage? One of the consequences of a spinal cord injury is Brown Sequard syndrome , which we will discuss throughout this article, as well as its symptoms, causes and possible treatments.
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What is Brown Sequard syndrome?
Brown Sequard syndrome is a condition first described in 1849 by the physiologist and neurologist Edouard Brown-Sequard ; which is distinguished by presenting a series of very specific neurological symptoms caused by a spinal cord injury. Specifically, this lesion refers to a medullar hemisection that generally damages the lateral half.
As a consequence, the person suffering from Brown Sequard syndrome experiences muscle weakness, numbness and paralysis which may differ from one person to another and the loss of sensibility of different areas of the body.
These effects tend to occur in active motor function below the point of the spinal cord where the lesion is located. In addition, the area affected by the paralysis is also located on the same side where the spinal damage has occurred.
In order to better understand how this syndrome affects the person suffering from it, it is necessary to clarify first that the spinal cord is an essential component of the nervous system, which is responsible for collecting and transmitting sensory and motor information of the various areas of the body, as well as the main brain nuclei. For this, it uses the nerves that are born along it.
Therefore, if the person suffers a trauma, or experiences the development of a tumor mass in the marrow that causes this hemisection, it is possible that this syndrome of Brown Sequard will appear and bring consequences such as these sensory alterations and pathologies associated with frailty and muscle paralysis.
The incidence of Brown Sequard syndrome is quite low, hence, it is categorized as a rare disease . Worldwide there are only between 30 and 40 cases of this disorder for every million people. In addition, research suggests that it affects a greater number of women than men; being the most affected age group between 16 and 30 years. However, the average age of patients suffering from this syndrome is about 40 years.
What symptomatology does it present?
Although the symptomatology may differ from one patient to another depending on how high the spinal cord is, the symptoms will usually be concentrated in three different categories: muscle weakness and paralysis, sensory perception and proprioception.
1. Muscle weakness and paralysis
As a consequence of the medullar hemisection characteristic of Brown Sequard syndrome, the person tends to experience important alterations in motor activities at the ipsilateral level. That is, in one of the two halves of the body.
The main motor symptoms associated with this syndrome are:
- Hemiparesis or reduced mobility of one half of the body.
- Hemiplegia or absolute paralysis of a half body .
- Bladder problems and loss of bladder control.
- Intestinal problems.
- Muscular atrophy and weakening.
- Problems in the ability to walk.
- Functional dependence
Proprioception is the sense that is responsible for inform our body of the position of our muscles . That is, our position. Thanks to him we can be aware and manage our movements and automatic reactions.
When this feeling is affected, in this case by the Brown Sequard syndrome, the person experiences a diminution of this corporal capacity.
3. Sensory perception
The main effects of Brown Sequard syndrome on the capacity of sensory perception are specified in the following symptoms:
- Hypoalgesia or loss of pain sensitivity contralateral to the affected area.
- Hypoesthesia or decreased sensitivity .
- Loss of sensitivity to changes in temperature.
- Ipsilateral loss of sensitivity to vibratory stimuli.
What are the causes of this syndrome?
There are a lot of factors that can cause a spinal cord injury . However, the most common cause that triggers Brown Sequard syndrome is a traumatic injury to the spine or neck.
As a rule, these injuries are usually the result of fractures or dislocations due to a fall or blow or, even, by some type of weapon injury. However, there are other causes related to the hospital environment. These refer to setbacks in a surgery or for damage when removing the drainage catheter from the cerebrospinal fluid.
As for the causes or organic alterations that can cause this syndrome include:
- Herniated discs.
- Transverse myelitis.
- Multiple sclerosis.
- Radiation .
- Epidural hematoma.
- Consumption of drugs .
- Herpes simplex
- Ischemia .
Treatment and prognosis
For the moment no specific treatment has been developed for Brown Sequard syndrome , so that medical and health personnel perform an individualized approach for each patient who suffers.
However, there are a number of general or common guidelines that consist of keeping the patient in a state of immobility to prevent further damage together with a series of surgical interventions and repairs.
On the other hand, the treatment also it is accompanied by the administration of a series of analgesic medications and corticosteroids to decrease the remaining symptoms of Brown Sequard.
Finally, these treatments are accompanied by a physiotherapeutic rehabilitation to support the tone and strength of the muscles, as well as an occupational rehabilitation that returns to the person the functional independence lost during the course of the disease.
As for the prognosis of Brown syndrome, this is usually favorable as long as treatment is started. As a rule More than 50% of patients tend to restore their motor capacity throughout the first year.