Brown - Sequard syndrome

Brown-Sequard syndrome is caused by hemisection of the spinal cord. It is characterised by:

• ipsilateral sensory loss of pressure, vibration, position, and flaccid paralysis at the level of the lesion
• spastic paraparesis below the level of the lesion
• contralaterally, loss of pain and temperature, usually 1 to 3 levels above the level of injury

Hemiplegia may initially present as flaccid due to acute spinal shock, so close monitoring of the neurologic examination is necessary. Injuries within the superior thoracic and cervical spine may also involve the spinal adjacent sympathetic chain, and evaluation for possible Horner Syndrome (miosis, anhydrosis, and ptosis) is warranted.

Reference

1. Ahuja CS, Wilson JR, Nori S, Kotter MRN, Druschel C, Curt A, Fehlings MG. Traumatic spinal cord injury. Nat Rev Dis Primers. 2017 Apr 27;3:17018.