S14.144
Brown-Séquard syndrome at C4 level of cervical spinal cord
Clinical Classification Guidelines
Medical Intelligence & Overview
Brown-Séquard syndrome is a rare neurological condition resulting from damage to one side (hemisection) of the spinal cord. When this injury occurs at the C4 level of the cervical spine, it can lead to specific sensory and motor deficits. This comprehensive guide provides an overview of the causes, symptoms, diagnosis, and management related to Brown-Séquard syndrome at this particular spinal level.
Causes & Symptoms
Clinical Causes: Trauma such as a traumatic injury or fracture to the cervical spine Penetrating injuries like stab wounds or gunshot wounds Spinal cord tumors or cysts compressing the cord Multiple sclerosis causing demyelination of the spinal cord Infections such as epidural abscesses or meningitis Degenerative conditions leading to spinal cord compression
Key Symptoms: Weakness or paralysis on one side of the body below the level of injury Loss of sensation (including pain, temperature, and touch) on the opposite side of the body below the injury Decreased or absent reflexes in the affected limbs Possible bladder or bowel dysfunction Pain or abnormal sensations such as tingling or burning in affected areas Muscle stiffness or spasms in certain muscles
Diagnostic & Treatment
Diagnosis Path: Medical history assessment focusing on recent trauma or neurological symptoms Physical examination testing muscle strength, sensation, reflexes, and coordination Magnetic Resonance Imaging (MRI) of the cervical spine to visualize the location and extent of spinal cord injury Computed Tomography (CT) scans if MRI is contraindicated or additional bony detail is needed Additional tests like evoked potentials or myelography may be considered in complex cases
Treatment Protocols: Emergency stabilization of the neck and spinal cord Immobilization and surgical intervention if there is ongoing compression or instability High-dose corticosteroids to reduce inflammation (though their use is controversial and should follow medical guidelines) Rehabilitation therapies including physical and occupational therapy to regain function and adapt to deficits Medications for managing pain, spasticity, or bladder and bowel issues Lifestyle modifications and assistive devices to enhance independence
Clinical Advice & FAQs
Billing Guidance
Is S14.144 a billable ICD-10 code?
Yes, S14.144 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.
Documentation
How do I report S14.144?
Clinical documentation must specify the nature of Brown-Séquard syndrome at C4 level of cervical spinal cord and any associated comorbidities for accurate reporting.
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