Brown sequard syndrome
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Brown-Sequard syndrome is caused by damage to one side of the spinal cord, resulting in different symptoms on each side of the body. It leads to ipsilateral weakness and loss of proprioception due to damage of the corticospinal tract and dorsal columns. There is also contralateral loss of pain and temperature sensation due to involvement of the lateral spinothalamic tract. Treatment focuses on prevention of complications and includes antibiotics to prevent infections, though steroids are controversial for traumatic injuries.
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No Title
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This document provides information on spinal cord injury, including classifications, anatomy, pathophysiology, assessment, and complications. It discusses two main classifications of spinal cord injury - complete and incomplete lesions. For incomplete lesions, it describes specific syndromes such as anterior cord, central cord, and Brown-Sequard. It also covers the anatomy and tracts of the spinal cord, neurogenic bladder dysfunction, and common complications of spinal cord injury such as respiratory issues, pressure sores, and urinary tract infections.
Paraplegias
1. The document discusses various types of spinal cord injuries including paraplegia, quadriplegia, and different syndromes that can result from lesions at specific levels of the spinal cord such as cervical, thoracic, lumbar, and conus medullaris.
2. It describes how to determine the level of a spinal cord lesion based on assessing the sensory level and signs of motor and autonomic dysfunction. Syndromes like Brown-Sequard and central cord are also summarized.
3. Common causes of compressive myelopathy include neoplastic etiologies with metastases most often occurring in the thoracic region.
The nervous system, parts, function, illness and diseases
The nervous system is the body's information gatherer, storage center and control system. It collects information from inside and outside the body and sends it to the brain for analysis, then sends signals to initiate responses. The nervous system consists of the central nervous system (brain and spinal cord) and peripheral nervous system (nerves connecting to the rest of the body). The peripheral system includes the somatic system for voluntary movement and autonomic system for involuntary functions like heart rate. The autonomic system has the parasympathetic and sympathetic divisions that work in opposition to regulate normal and stress responses. Common nervous system diseases include Alzheimer's, which causes dementia, and Parkinson's, characterized by movement issues from dopamine neuron loss.
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Spinal Cord Disease - Clinical Presentations and Management
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Brown sequard syndrome
- 1. BY ASSMAA FREAH 121-i1b BROWN SEQUARD SYNDROME (BSS)
- 2. PLAN CAUSES How it occurs What are the main causes Can he be completely cured How is it treated The Diagnosis What’s happening during it TREATMENT SYMPTOMS 01 02 03
- 3. BACKGROUND Brown sequard syndrome which is also known as transverse hemisection syndrome or Hemiplegia syndrome It’s a disease when one half of the spinal cord is injured or damaged that’s why it’s Classified as an incomplete cord syndrome Charles-Édouard Brown-Séquard
- 5. Sensation-stimulated receptors passes the information to the CNS via afferent (sensory) fibers (ascending pathways) NEURAL TRACTS Passes information from the CNS to the muscles and nerves to produce a rapid motor response (Descending pathways) MOTOR SENSORY
- 6. ASCENDING PATHWAYS -Contain a sequence of THREE neurons from the receptor to the cerebral cortex -First order neuron: Sensory neuron that delivers information from the receptor to the CNS. -Second order neuron: Has cell body in the spinal cord or medulla oblongata. And terminates on the 3rd order neuron -Third order neuron: Has cell body in thalamus Axon terminates on cerebral cortex ipsilaterally
- 7. DESCENDING PATHWAYS -Contain a sequence of TWO neurons from the CnS to the muscle -UMN: delivers information from the cerebral hemisphere to the spinal cord LMN: delivers information from the anterior horn cells to the muscle
- 8. SENSORY AND MOTOR PATHWAYS
- 9. -Ipsilateral loss of proprioception due to posterior column involvement. -Contralateral loss of pain and temperature due to involvement of lateral spinothalamic tract. SYMPTOMS -Ipsilateral spastic weakness due to descending corticospinal tract involvement -LMN signs at the level of lesion. MOTOR SENSORY
- 10. BSS DIAGNOSIS Diagnosis of Brown sequard Syndrome is made by neurological history, any trauma history, and physical examination. Laboratory investigations in case of infectious etiologies like purified protein derivative and sputum for acid-fast bacilli along with chest x-ray. MRI or X-ray when traumatic injuries are in suspected as well as neoplastic causes.
- 11. CAUSES BROWN SEQUARD SYNDROME may occur as a result of spinal cord damage caused by spinal cord tumors, injuries [such as falls, gunshot injury], ischemia, infectious or inflammatory diseases such as tuberculosis or multiple sclerosis.
- 12. BSS PATHOPHYSIOLOGY Damage of Corticospinal tract below the level of pyramidal decussation: • Corticospinal tract crosses at the level of the brainstem, the lesions below it will produce ipsilateral symptoms. • Ipsilateral Upper Motor Neuron Lesions below the level of injury
- 13. BSS PATHOPHYSIOLOGY 2. Damage of Lower Motor Neurons at the level of Injury: • Ipsilateral Lower Motor Neuron Lesions at the level of injury
- 14. BSS PATHOPHYSIOLOGY 3. Damage of Dorsal column below the level of sensory decussation: • Dorsal column crosses at the level of the brainstem, the lesions below it will produce ipsilateral symptoms. • Ipsilateral loss of joint position sense, tactile discrimination, fine touch and vibratory sensations at and below the level of injury.
- 15. BSS PATHOPHYSIOLOGY 4. Damage of Spinothalamic tract: • Information ascends contralaterally in the spinal cord (crosses in the spinal cord). • Carries fibres for Pain, Temperature and Crude Touch. • At the level: • Ipsilateral loss of: • Pain • Temperature • Crude touch • Because fibers are • not crossed yet at that level Below the level: -Contralateral loss of: Pain Crude touch
- 16. BSS TREATMENT The treatment for individuals with Brown-Sequard syndrome depends on the cause and is focused on preventing the complications. Use of steroids is controversial in traumatic spinal cord injuries due to the risk of infections, and they are not effective in case of Brown-Sequard syndrome, but standard perioperative prophylactic antibiotics are recommended.