BrownSequard

Brown-Séquard syndrome is a neurological condition caused by unilateral damage to the spinal cord, typically a hemisection. The deficit pattern follows the anatomy of the major tracts: ipsilateral weakness and loss of proprioception and vibration below the lesion, and contralateral loss of pain and temperature beginning a few levels below. This creates a characteristic combination of motor and sensory findings on opposite sides of the body.

Most cases arise from penetrating trauma such as gunshot or stab injuries, but can also result from spinal tumors, ischemia, disc herniation, demyelinating disease, or iatrogenic injury. The clinical picture may include segmental signs at the level of the lesion and a mix of upper motor neuron signs below it on the same side, with sensory loss on the opposite side.

Diagnosis is based on clinical examination and is supported by magnetic resonance imaging of the spine to identify the lesion and its extent. Treatment focuses on addressing the underlying cause, stabilizing the spine if trauma is present, and initiating rehabilitation. The use of high-dose corticosteroids is controversial and not routinely recommended in modern practice. Prognosis varies with the level and extent of injury, with some patients recovering function through early intervention and intensive rehabilitation, while others retain deficits.

The syndrome is named after Charles-Édouard Brown-Séquard, who first described the concept in the 19th century.