A rare neurological condition known as brown sequard syndrome (BSS) results in weakness or paralysis on one side of the body and loss of sensation on the opposite side when one side of the spinal cord is damaged. With the help of the spinal cord, we are able to move, feel, and control vital functions of our bodies. Injuries to the spinal cord can alter these abilities, depending on the extent and location of the injury.
BSS can be caused by various factors, both traumatic and non-traumatic. Traumatic causes include:
Stab or gunshot wounds
Falls
Vehicular accidents
Blunt force trauma
Non-traumatic causes include:
Genetic spinal malformations
Infections such as meningitis, myelitis, herpes, and tuberculosis
Radiation exposure
Multiple sclerosis
Epidural hematomas (blood clots inside the skull)
Spinal ischemia (reduced blood supply to the spine)
Spinal disorders such as cervical spondylosis
Arachnoid cysts (fluid-filled sacs in the brain)
Intravenous drug use
Spinal cord tumors
Herniated discs
Decompression sickness (bubbles in the blood due to rapid pressure changes)
The symptoms of BSS vary depending on the level and severity of the spinal cord injury. The most common symptoms are:
Muscle weakness or paralysis on the same side of the injury
Loss of pain and temperature sensation on the opposite side of the injury
Loss of touch, vibration, and position sensation on the same side of the injury
Spasticity (stiffness and increased reflexes) on the same side of the injury
Bladder and bowel dysfunction
Sexual dysfunction
Low blood pressure
Difficulty breathing
The symptoms usually appear immediately or shortly after the injury and may improve over time with treatment and rehabilitation.
The doctor will ask about the cause and onset of the symptoms, as well as any other medical conditions or medications the patient takes. BSS is diagnosed based on a patient's medical history, physical examination, and imaging tests. To test the patient's muscle strength, reflexes, and sensation, the doctor will also perform a neurological exam. A spinal cord injury may be diagnosed with imaging tests such as X-rays, CT scans, MRI scans, or myelography to confirm its location and extent.
There is no specific treatment for BSS, but the goal is to prevent further damage, reduce inflammation, manage symptoms, and improve function and quality of life. The treatment options may include:
Medications such as steroids, painkillers, antispasmodics, and antibiotics
Surgery to remove any foreign objects, blood clots, tumors, or cysts that are compressing the spinal cord
Spinal stabilization to prevent further movement or displacement of the injured spine
Physical therapy to strengthen the muscles, improve mobility, and prevent complications such as contractures and pressure ulcers
Occupational therapy to help the patient perform daily activities and adapt to the changes in function
Speech therapy to help the patient communicate and swallow
Psychological counseling to help the patient cope with the emotional and social impact of the injury
Assistive devices such as braces, splints, wheelchairs, or catheters to aid the patient’s independence and comfort
BSS is not always preventable, but some measures can be taken to reduce the risk of spinal cord injury, such as:
Wearing seat belts and helmets when driving or riding a vehicle
Avoiding alcohol and drugs that can impair judgment and coordination
Following safety rules and regulations when working or playing in hazardous environments
Seeking medical attention promptly for any signs of infection, inflammation, or neurological problems
Maintaining a healthy lifestyle with regular exercise, balanced diet, and adequate hydration
BSS is a rare and severe condition that affects the spinal cord and its functions. It can be caused by several factors, both traumatic and non-traumatic, and can result in muscle weakness or paralysis on one side of the body and loss of sensation on the other. Based on the patient's medical history, physical examination, and imaging tests, the diagnosis is made. The treatment aims to prevent further damage, reduce inflammation, manage symptoms, and improve function and quality of life. Prognosis depends on the severity and level of the injury, the patient's age and health, as well as the availability and quality of the rehabilitation and treatment available to the patient. It is not always possible to prevent spinal cord injuries, but some measures can be taken to reduce the risk. Although BSS is a challenging condition that requires ongoing medical care and support, many patients can lead productive and fulfilling lives with proper treatment and rehabilitation.
