S14.14

Clinical Causes: Trauma to the neck or cervical spine, such as from car accidents, falls, or sports injuries Tumors or growths compressing the spinal cord Spinal cord infections or inflammation Multiple sclerosis causing demyelination of nerve fibers Vascular injuries leading to hemorrhage or ischemia in the cervical spinal cord Spinal cord infarction or stroke at the cervical level Previous surgical interventions or radiation therapy affecting the cervical spine

Key Symptoms: Weakness or paralysis on one side of the body below the level of injury Loss of pain and temperature sensation on the opposite side of the body Preserved or less affected proprioception and vibration sense on the same side as the weakness Possible sensory deficits on the same side as the motor weakness Difficulty with coordination and balance Muscle stiffness or spasticity in affected limbs Potential bladder and bowel dysfunction depending on the severity and location of injury

Diagnosis Path: Diagnosis of Brown-Séquard syndrome involves a comprehensive clinical examination, including neurological assessment to identify patterns of motor and sensory loss. Imaging studies such as magnetic resonance imaging (MRI) are critical to visualize the extent and location of spinal cord damage or lesions. Additional tests may include X-rays or CT scans to evaluate for fractures or structural abnormalities. In some cases, electrophysiological studies like somatosensory evoked potentials (SSEPs) or motor evoked potentials (MEPs) help assess nerve function.

Treatment Protocols: Management strategies for Brown-Séquard syndrome depend on the underlying cause and severity of the injury. Initial treatment may include corticosteroids to reduce inflammation, immobilization to prevent further injury, and surgical interventions if structural issues like tumors or compressive lesions are identified. Rehabilitation plays a vital role, encompassing physical therapy to improve mobility and strength, occupational therapy for daily living skills, and management of secondary complications such as spasticity or bladder dysfunction. Long-term care involves a multidisciplinary approach to optimize recovery and adapt to any lasting deficits.