Episode 18: Brown Sequard Syndrome

Notes by Alexis Lancaster, SPT

What is it?

  • Damage to one side of the spinal cord

 

Mechanism of injury:

  • MVA, gunshot wound, stab wound

 

Impairments/presentation:

  • Ipsilateral losses: proprioception, vibration, deep touch, discriminative touch, and voluntary motor control
  • Contralateral losses: pain, temperature, crude touch

 

Differential diagnosis:

  • Other spinal cord injuries (see above impairments list and differentiate this way)
  • MS
  • Spinal infarct
  • Spinal tumor
  • Transverse myelitis

 

Special tests:

  • CT, MRI
  • Clinical presentation

 

Treatment:

    • Medically stable/managed
    • Bowel/bladder program
    • Task-specific training
    • Motor learning
    • Neuromuscular re-education
    • Weight-bearing
    • Tone management
    • FES
    • Aerobic training
    • Positioning, splinting, bracing
    • Keep an eye on shoulder pain

 

  • Allow for compensation!! (This is different, usually with the neurological population you want to use less compensation and aim for recovery of function, but these patients will need to compensate some)

 

 

How it will appear on the test:

  • Know how it presents clinically
  • Know the type of injury that may result in Brown-Sequard