Brown Sequard syndrome: causes, symptoms, and treatment.

One of the rare diseases of the nervous system that can produce loss of sensitivity.

The spinal cord is one of the most important components of our body; thanks to it, our brain and the rest of our body are in constant communication.

However, what happens if the spinal cord is damaged? One of the consequences of a spinal cord injury is the Brown Sequard syndrome, which we will talk about later on.of which we will speak throughout this article, as well as of its symptoms, causes and possible treatments.

What is Brown Sequard syndrome?

Brown Sequard syndrome is a condition described for the first time in the years 1849 by the physiologist and neurologist Edouard Brown-SequardThis disease is distinguished by a series of very specific neurological symptoms caused by a lesion in the spinal cord. Specifically, this lesion refers to a spinal cord hemisection that generally affects the lateral half of the spinal cord.

As a result, the person suffering from Brown Sequard syndrome experiences muscular weakness, numbness and paralysis which may differ from person to person, and loss of sensation in different areas of the body.

These effects tend to occur in the active motor function below the point on the spinal cord where the lesion is located. In addition, the area affected by the paralysis is also located on the same side where the spinal cord damage has occurred.

In order to better understand how this syndrome affects the person who suffers from it, it is necessary to first clarify that the spinal cord is an essential component of the nervous system, which is responsible for collecting and transmitting sensory and motor information from the various areas of the body, as well as from the main brain nuclei. and motor information from the various areas of the body, as well as from the main brain nuclei. To do this, it uses the nerves that are born along it.

Therefore, if the person suffers a trauma, or experiences the development of a tumor mass in the medulla that causes this hemisection, it is possible that this Brown Sequard syndrome may appear and lead to consequences such as these sensory alterations and pathologies associated with muscular fragility and paralysis.

Prevalence

The incidence of Brown Sequard syndrome is quite low, hence it is categorized as a rare disease.. Worldwide, there are only 30 to 40 cases of this disorder per million people. In addition, research indicates that it affects a greater number of women than men; the most affected age group is between 16 and 30 years of age. However, the average age of patients suffering from this syndrome is approximately 40 years old.

What are the symptoms?

Although the symptomatology may differ the symptomatology may differ from one patient to the next depending on the height of the spinal cord lesion, symptoms will generally be concentrated in three distinct categories: Muscle weakness and paralysis, sensory perception and proprioception.

Muscle weakness and paralysis

As a consequence of the spinal cord hemisection characteristic of Brown Sequard Syndrome, the person tends to experience important alterations in motor activities at the ipsilateral level. ipsilateral level. That is to say, in one of the two halves of the body.

The main motor symptoms associated with this syndrome are:

• Hemiparesis or reduced mobility of one half of the body.
• Hemiplegia or absolute paralysis of one half of the body.
• Bladder problems and loss of bladder control.
• Intestinal problems.
• Muscle atrophy and weakening.
• Problems in the capacity to walk.
• Functional dependence.

2. Proprioception

Proprioception is the sense that is in charge of informing our organism of the position of our muscles.. In other words, our posture. Thanks to it, we can be aware of and manage our movements and automatic reactions.

When this sense is affected, in this case by Brown Sequard syndrome, the person experiences an impairment of this bodily capacity.

3. Sensory perception

The main effects of Brown Sequard syndrome on the sensory perception capacity are the following symptoms:

• Hypoalgesia or loss of sensitivity to pain contralateral to the affected area.
• Hypoesthesia or decreased sensitivity.
• Loss of sensitivity to temperature changes.
• Ipsilateral loss of sensitivity to vibratory stimuli.

What are the causes of this syndrome?

There are a large number of factors that can cause a spinal cord injury. However, the most common cause that triggers Brown Sequard syndrome is a traumatic injury to the spine or neck.

As a general rule, these injuries usually result from fractures or dislocations from a fall or blow, or even from some type of weapon injury. However, there are other causes related to the hospital setting. These refer to mishaps in surgery or damage during removal of the cerebrospinal fluid drainage catheter.

As for the causes or organic alterations that may lead to this syndrome, they include:

• Herniated discs.
• Tumors.
• Transverse myelitis.
• Multiple sclerosis.
• Radiation.
• Tuberculosis.
• Epidural hematoma.
• Drug use..
• Hemorrhage.
• Syphilis.
• Herpes simplex.
• Ischemia.
• Ossifications.
• Meningitis.

Treatment and prognosis

At the moment no specific treatment for Brown Sequard syndrome has been developed.Therefore, medical and sanitary personnel carry out an individualized approach for each patient who suffers from it.

However, there are a series of general or common guidelines which consist of keeping the patient in a state of immobility in order to prevent further damage together with a series of interventions and surgical repairs.

On the other hand, the treatment is also is also accompanied by the administration of a series of analgesic drugs. and corticosteroids to reduce the remaining symptoms of Brown Sequard.

Finally, these treatments are accompanied by physiotherapeutic rehabilitation to support muscle tone and strength, as well as occupational rehabilitation to restore the person's functional independence lost during the course of the disease.

The prognosis of Brown's syndrome is usually favorable as long as treatment is initiated. As a general rule more than 50% of the patients tend to re-establish their motor capacity within the first year. within the first year.