Overview
Brown-Sequard syndrome (BSS) involves ipsilateral motor and proprioceptive deficits with contralateral pain and temperature loss, typically due to hemisection injury at a specific spinal level. At the C5 level, it manifests with weakness and sensory loss affecting the upper limb and trunk on one side, with contralateral pain and thermal insensitivity 1.Diagnosis
Clinical Presentation: Ipsilateral motor and proprioceptive deficits, contralateral pain and temperature loss 1.
Imaging: MRI or CT myelography to identify the lesion and extent of spinal cord damage 1.
Neurological Examination: Detailed assessment for sensory and motor asymmetry 1.Management
Corticosteroids: Early administration to reduce inflammation and improve neurological outcomes 1.
Free Radical Scavengers: Adjunctive therapy to mitigate oxidative stress 1.
Rehabilitation: Early mobilization and physical therapy to support recovery 1.Special Populations
Elderly: Response to treatment may vary; close monitoring and supportive care are essential 1.Key Recommendations
Initiate corticosteroid therapy promptly after diagnosis to potentially improve neurological recovery (Evidence: Moderate 1).
Consider adjunctive use of free radical scavengers alongside corticosteroids to support neuroprotective effects (Evidence: Weak 1).
Implement early rehabilitation strategies including physical therapy to enhance functional recovery (Evidence: Expert opinion 1).References
1 Ozaki N, Wakita N, Inoue K, Yamada A. Brown-Sequard syndrome after thoracic endovascular aortic repair. Interactive cardiovascular and thoracic surgery 2010. link