Curriculum · Neurology
Brown-Sequard syndrome
What it is
Brown-Séquard syndrome is hemisection of the spinal cord: one half of the cord is taken, so the loss is split between the two sides of the body. It sits in the same list as complete transection of the cord, which instead takes all sensation below the level of the lesion.
How it presents
The findings go by side and by level:
- Ipsilateral loss of all sensation at the level of the lesion.
- Ipsilateral LMN signs at the level of the lesion, for example flaccid paralysis.
- Ipsilateral UMN signs below the level of the lesion, from corticospinal tract damage.
- Ipsilateral loss of proprioception, vibration, light touch with 2-point discrimination, and tactile sense below the level of the lesion, from dorsal column damage.
- Contralateral loss of pain, temperature and crude touch below the level of the lesion, from spinothalamic tract damage.
In short, joint position, vibration and light touch go on the same side, and pain and temperature go on the opposite side. If the lesion occurs above T1 the patient may also present with an ipsilateral Horner syndrome due to damage of the oculosympathetic pathway.