Brown-Sequard Syndrome

Brown-Séquard Syndrome

The Brown-Séquard syndrome is the consequence of anatomical or, more usually, functional hemisection of the spinal cord (spinal hemisection syndrome), producing the following pattern of clinical findings:

• Motor:
  • Ipsilateral spastic weakness, due to corticospinal tract involvement;
  • Segmental lower motor neurone signs at the level of the lesion, due to root and/or anterior horn cell involvement.
• Sensory:
  • A dissociated sensory loss, i.e.:
    Ipsilateral loss of proprioception, due to dorsal column involvement;
    Contralateral loss of pain and temperature sensation, due to crossed spinothalamic tract involvement.

Spinal cord lesions producing this syndrome may be either extramedullary (e.g., prolapsed cervical intervertebral disc, extrinsic spinal cord tumor) or intramedullary (e.g., multiple sclerosis, intrinsic spinal cord tumor); the former group is said to be the more common cause.

References

Aminoff MJ. Brown-Séquard. A visionary of science. New York: Raven, 1993: 112-131
Engelhardt P, Trostdorf E. Zur Differentialdiagnose des Brown-Séquard-Syndroms. Nervenarzt 1997; 48: 45-49
Tattersall R, Turner B. Brown-Séquard and his syndrome. Lancet
2000; 356: 61-63

Cross References

Dissociated sensory loss; Myelopathy; Proprioception; Spasticity; Weakness