Brown-Séquard: Which statement best describes this syndrome?

Brown-Séquard: Which statement best describes this syndrome?

• A. It is a lesion of the brainstem
• B. It is a full transection of the spinal cord
• C. It is a hemisection of the spinal cord with trauma-induced, producing motor, sensory, and autonomic symptoms on the same side
• D. It is a disorder of peripheral nerves

Answer: (C)

Brown-Séquard syndrome comes from a hemisection of the spinal cord, usually due to penetrating trauma. The key pattern is asymmetric: on the side of the lesion there is motor weakness with upper motor neuron signs below the level (corticospinal tract damage) and loss of vibration/proprioception (dorsal column damage). Motor and dorsal-column deficits are ipsilateral. Pain and temperature loss, however, occur on the opposite side because the spinothalamic tract fibers cross within a few levels of entry and then ascend contralaterally. Autonomic dysfunction can accompany the ipsilateral side depending on the level of injury, such as bladder or autonomic symptoms, but the hallmark pattern remains the combination of ipsilateral motor and sensory (dorsal column) loss with contralateral pain/temperature loss below the lesion. This best describes a half-spinal-cord injury from trauma, rather than a brainstem lesion, a complete transection (which would cause bilateral deficits below the level), or a peripheral nerve disorder (which would affect specific nerves rather than tracts across one side of the cord).

Brown-Séquard syndrome comes from a hemisection of the spinal cord, usually due to penetrating trauma. The key pattern is asymmetric: on the side of the lesion there is motor weakness with upper motor neuron signs below the level (corticospinal tract damage) and loss of vibration/proprioception (dorsal column damage). Motor and dorsal-column deficits are ipsilateral. Pain and temperature loss, however, occur on the opposite side because the spinothalamic tract fibers cross within a few levels of entry and then ascend contralaterally. Autonomic dysfunction can accompany the ipsilateral side depending on the level of injury, such as bladder or autonomic symptoms, but the hallmark pattern remains the combination of ipsilateral motor and sensory (dorsal column) loss with contralateral pain/temperature loss below the lesion.

This best describes a half-spinal-cord injury from trauma, rather than a brainstem lesion, a complete transection (which would cause bilateral deficits below the level), or a peripheral nerve disorder (which would affect specific nerves rather than tracts across one side of the cord).