S14.145

Clinical Causes: Traumatic injuries such as car accidents, falls, or sports injuries leading to spinal cord compression or laceration. Penetrating injuries like stab wounds or gunshot wounds affecting the cervical spine. Spinal tumors or malignancies invading the cervical cord. Infections such as abscesses or meningitis that cause inflammation and damage to the spinal cord. Multiple sclerosis or other demyelinating diseases resulting in focal damage.

Key Symptoms: Unilateral (one-sided) weakness or paralysis, typically affecting the muscles below the level of injury. Loss of sensation on the opposite side of the body, including pain, temperature, and crude touch. Preserved or increased reflexes on the affected side, leading to spasticity. Decreased or absent proprioception and vibration sense on the same side as the weakness. Possible bowel and bladder dysfunction depending on the extent of the injury. Pain or abnormal sensations at or below the level of injury.

Diagnosis Path: Diagnosis involves a combination of clinical assessment and imaging studies. Healthcare providers perform thorough neurological examinations to evaluate motor strength, sensory function, and reflexes. Magnetic Resonance Imaging (MRI) of the cervical spine is the preferred imaging modality, as it provides detailed views of the spinal cord to identify areas of injury, compression, or lesions. Additional tests such as X-rays and CT scans may assist in evaluating structural damage or fractures. Neurophysiological studies like somatosensory evoked potentials can also aid in assessing the extent of nerve pathway disruption.

Treatment Protocols: Management of Brown-Séquard syndrome focuses on stabilization, preventing further injury, and addressing specific symptoms. Initial treatment may include immobilization of the neck, corticosteroids to reduce inflammation, and surgical intervention if necessary to decompress the spinal cord or stabilize the spine. Long-term care involves a multidisciplinary approach, including physical and occupational therapy to regain or maximize motor and sensory functions. Medications may be prescribed for pain management and spasticity control. In some cases, assistive devices and adaptive equipment are used to enhance mobility and independence. Ongoing rehabilitation and support are crucial for improving quality of life.