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



  • 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



    • 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