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Thread: brown-sequard

  1. #1
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    brown-sequard

    hello,
    my brother was recently diagnosed with brown secourd syndrome. is there a difference between this and a spi? does anybody else out there have this? does it matter how high up your were hit? his is at the c2. he wants to know if the numbness goes away? what does it feel like to go in pool if he can't feel hot or cold very well? are there any other on-line resources for him to check out?
    thanks for any info!
    lisa
    thanks,

  2. #2
    Brown-Sequard syndrome is a type of incomplete spinal cord injury. It is seen most in cervical injuries. It occurs when the spinal cord is damaged more on one side than the other, often from tumors or stabs or gun shot wounds. This results in paralysis or weakness on the same side of the body, but loss of or decreased sensation to hot/cold and pain on the opposite side. Generally sensation is fairly good on the weak side. Proprioception (position sense) is often impaired on both sides.

    This type of SCI can be a major challenge in relationship to safety, as it is easy to get injuries (cuts or burns) on the less impaired side. He needs to learn how to test water temperature, etc. on his weaker side before letting his stronger side get into the bathtub, for example. He needs to be extra caution about avoiding cuts or bruises on this side also.

    As an incomplete SCI, there is a good chance of some significant return of function and feeling, but this may take months or years to know how much he will get back. When was he injured?

    Is he still in rehab? They should be teaching him how to manage both his mobility and self care and his safety in anticipation of his return home.

    Get him on-line to this site. This is the best place for him to get more information. Encourage him to register and join us!

    (KLD)

  3. #3
    I have brown sequard as a result of my C5/6 injury. For me, sensation seems totally normal throughout my body. The side that is impaired can't really distinguish hot/cold or pain sensations. Everything feels normal, but water for example feels luke warm no matter what temperature is it.

  4. #4
    I'm a c5-6 with Brown Sequard. I guess any level of injury can get this. My sensation is pretty far off. Some of the numbness went away. Tell him the pool feels great. I got a lot of return in pool therapy. How long has he been injured? A lot of us w/ Brown Sequard are walking quads-most don't walk great but it beats not walking at all. Tell him he needs to bust his butt in rehab.

    Check out this article for answers to questions I'm sure you and he have:

    http://carecure.rutgers.edu/spinewir...I/AcuteSCI.htm

    Let us know what else you need, and SCI Nurse is right, by all means gets him in here.

    There are lots of online resources, what are you wanting to know about?

    Good luck and holler if you need us-Beth

    Can't stop the spirits when they need you/This life is more than just a read thru.-
    red Hot Chili Peppers

  5. #5
    Lisa,

    Charles Edward Brown-Secquard is an English neurologist who worked at the Institute of Neurology at Queen's Square, London. He was the first neurologist to work on the fact that pain sensory fibers cross over to the other side in the spinal cord while proprioceptive sensation (touch and joint positions) are carried in the dorsal column tracts that cross over to the other side in the brainstem. Descending motor pathways from the brain cross over to the other side in the brainstem. Because of the different locations of the fiber tracts crossing over, if the spinal cord is damaged on one side, it will result in motor weakness and loss of touch/position sensation on that that side and loss of pain and temperature sensation on the other side.

    As legend has it (and there is still a room at the Institute of Neurology in Queen's Square, London that has all his clinical notebooks), he described the Brown-Sequard syndrome in London dockworkers who had been punished by the Mafia by inserting a stiletto into the spinal cord and cutting half of their spinal cords.

    Your brother has had half of the spinal cord injured. The injury to the spinal cord is on the side of his motor weakness. You would get the syndrome if half of the spinal cord is damaged anywhere in the cervical and thoracic spinal cord. The manifestations of injuries to the lumbosacral spinal cord are more difficult to interpret because it may involve spinal roots and also parts of the spinal cord that innervate the legs and pelvic area.

    Most people with Brown-Sequard will recovery walking. The reason is because the descending motor tracts on one side of the spinal cord are sufficient to stimulate the locomotor pattern generator that is located at about L2 lumbar spinal cord. The pattern generator will drive reciprocal stepping of both legs, even though the direct descending motor control of the leg muscles may be lost.

    The diagnosis of Brown-Sequard is clear if a person has better touch sensation on one side and pain (pinprick) sensation on the other side of the body. Hemiplegia (weakness on one of side of the body) can occur if there is damage to the brain on the other side of the weak side. For example, a person with a stroke on the left brain will show weakness, as well as loss of both pinprick and touch sensation, on the right side of the body.

    Your brother needs to be carefuly on the leg where he has lost pain/temperature sensation. Without feeling pain in that leg, he may inadvertently hurt the leg. If he is stepping into a hot bath, he should use the leg that is stronger to test the water temperature (or better, use his hand).

    I agree with Betheny that it is important for your brother to "bust his butt in rehab". The more he walks and exercise, the more likely he will recover much more function.

    Wise.

  6. #6
    Wise, I think you meant to say to use the WEAKER side to test temperature. This is the side that usually has pain and temperature sparing. The stronger side is better for touch sensation.

    (KLD)

  7. #7
    Lisa, I also have Brown-Sequard syndrome. I was diagnosed with it at four months post at my first visit with my rehab physician (why other docs missed it I don't know because it seems obvious to me now). He told me that I had a very good chance of walking again which thrilled me because I was firmly planted in my chair at the time. He was right as I now walk with a cane.

    KLD, you are right. I have to use my weaker side to test water temperature. I am used to it now but at first I would test the water with my left hand only to find it was much too hot for my right.

    Wise, I knew about the stiletto, but not that it was London dockworkers who were afflicted with that particularly cruel form of torture. Thanks for filling in the detail. Next time I'm in London I may have to pay a visit to the Institute of Neurology.

    [This message was edited by bruce hanson on 12-11-04 at 08:40 PM.]

  8. #8
    KLD, you're right. Sorry. Wise.

  9. #9
    So, if a person had an injury that resulted in a right side weakness, and a left side with reduced temperature and pain sensation does that mean that the injury occured on the right side of the spinal cord? Thanks!

  10. #10
    Correct.

    (KLD)

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