Brown-Sequard syndrome at the level of injury is classically described as a hemisection of the spinal cord with which pattern of deficits?

Brown-Sequard syndrome at the level of injury is classically described as a hemisection of the spinal cord with which pattern of deficits?

• A. Hemissection of the spinal cord resulting in ipsilateral loss of touch, proprioception, and motor with bilateral loss of pain and temperature and LMN signs at the level.
• B. Complete transection of the spinal cord with bilateral loss of all modalities.
• C. Lesion of the posterior column with contralateral loss of pain.
• D. Damage to anterior horn cells causing only motor weakness.

Answer: (A)

Brown-Sequard syndrome happens when one side of the spinal cord is damaged. The pattern you see comes from how the major tracts run and cross: - On the same side as the injury, the corticospinal tract (motor) and the dorsal columns (touch and proprioception) are affected. That means weakness or paralysis and loss of fine touch and position sense on the same side below the lesion. - The spinothalamic tract, which carries pain and temperature, crosses to the opposite side within a couple of segments after entering the cord. So pain and temperature loss appears on the opposite side, beginning a few levels below the injury. - At the exact level of injury, there can be LMN signs due to direct involvement of the ventral horn cells or exiting nerve roots. So the classic description is: ipsilateral loss of motor control and dorsal-column modalities, with contralateral loss of pain and temperature below the lesion, and LMN signs at the level of the injury. The idea that pain and temperature loss is bilateral isn’t accurate; it’s contralateral to the lesion.

Brown-Sequard syndrome happens when one side of the spinal cord is damaged. The pattern you see comes from how the major tracts run and cross:

• On the same side as the injury, the corticospinal tract (motor) and the dorsal columns (touch and proprioception) are affected. That means weakness or paralysis and loss of fine touch and position sense on the same side below the lesion.

• The spinothalamic tract, which carries pain and temperature, crosses to the opposite side within a couple of segments after entering the cord. So pain and temperature loss appears on the opposite side, beginning a few levels below the injury.

• At the exact level of injury, there can be LMN signs due to direct involvement of the ventral horn cells or exiting nerve roots.

So the classic description is: ipsilateral loss of motor control and dorsal-column modalities, with contralateral loss of pain and temperature below the lesion, and LMN signs at the level of the injury. The idea that pain and temperature loss is bilateral isn’t accurate; it’s contralateral to the lesion.