Brown-Sequard Syndrome

General Features

  • Brown-Séquard syndrome occurs due to lateral hemisection of the spinal cord
  • Unilateral involvement of the dorsal column, corticospinal tract, and spinothalamic tract
  • Causes of spinal cord hemisection include penetrating trauma from a stab, bullet, or fracture-disclocation, spinal cord tumor, disc herniation, syringomyelia, or hematomyelia
  • Ipsilateral loss of motor function and proprioception (same side of lesion)
  • Hemisection causes damage to the ipsilateral descending motor pathways and ascending proprioceptive pathways which cross in the brainstem
  • The corticospinal tract is disrupted, which carries motor function
  • The dorsal column is disrupted, which carries proprioception (position sense and vibratory sense)
  • Contralateral loss of pain and temperature sensation (opposite side of lesion)
  • Hemisection causes damage to the contralateral sensory pathways for pain and temperature which cross at their spinal root levels
  • Pain/temperature loss occurs below the level of the lesion
  • The spinothalamic tract is disrupted, which carries pain and temperature sensation from the contralateral side of the body