- What is Brown-Sèquard Syndrome
Brown- Séquard Syndrome can be divided into traumatic and non-traumatic injuries – with traumatic injuries being far more common. Typically, gun wounds, stabbing, car accidents, truck accidents, motorcycle accidents, blunt trauma or a fractured vertebra from a fall could be among the causes of this type of spinal cord injury.
Traumatic Brown-Sèquard syndrome is a rare type of incomplete spinal cord injury that occurs when half of the spinal cord is damaged. Approximately 2% of spinal cord injuries are classified as Brown-Sèquard syndrome. It is named after Charles-Édouard Brown-Séquard, a physiologist who discovered this particular condition in 1850.
Individuals with Brown-Sèquard syndrome may find that they have different symptoms and experiences on opposite sides of the body and can experience significant difficulty with mobility and function in the lower body. Thus, undiagnosed Brown-Sèquard syndrome can render the individual paralyzed or partially paralyzed.
Brown-Sèquard syndrome generally comes with a positive prognosis and higher chances of the individual recovering to regain mobility. However, as with all types of incomplete spinal cord injury, this requires significant time and focus on regular treatments such as physical therapy and lifestyle changes.
With the right resources and information, recovery for you or your loved one from Brown-Sèquard syndrome is possible, and your quality of life can increase. As Hamilton personal injury lawyers, we have worked with individuals with varying types of spinal cord injuries and have obtained a significant amount of information that can be helpful to those who are recovering.
Understanding Brown-Sèquard Syndrome and its Classification
Brown-Sèquard syndrome occurs when the individual suffers damage to one-half of the spinal cord without severing it completely. This is also referred to as hemisection of the spinal cord.
Often, this damage occurs in the upper part of the spine, known as the cervical spine (neck) or the back. For example, it is commonly caused by an individual being stabbed in the neck or punctured in the neck during an accident. This type of trauma can penetrate one side of the spinal cord without entirely damaging or separating it, causing hemisection.
Individuals with Brown-Sèquard syndrome experience paralysis and loss of sensation on the side of the body where the injury occurs, while the other side experiences loss of temperature and pain reception. This loss of function occurs in the lower body, below the injury site. Sometimes, the loss of sensation on the opposite side of the body from the injury can be located in one or two segments lower than the level of injury.
This contralateral pain construction is the classifying element of Brown-Séquard syndrome and is a vital component of diagnosis.
Types of Brown-Sèquard Syndrome
There are two alternative forms of Brown-Sèquard syndrome: Brown-Sèquard plus syndrome and partial Brown-Sèquard syndrome. Both versions of the condition are more commonly diagnosed than the “regular” or “pure” version of Brown-Sèquard syndrome.
Brown-Sèquard Plus syndrome is diagnosed when an individual with Brown-Sèquard syndrome is discovered to have undergone additional neurological damage or issues with the eyes, bowels, or bladder. In a study, individuals with Brown-Sèquard Plus syndrome had a better prognosis than other versions of the condition.
Partial Brown-Sèquard syndrome is the most common type of Brown-Sèquard syndrome and refers to the particular extent of the damage. This generally manifests as a non-traumatic version and is often used to refer to the condition when it develops based on an individual’s medical history or previously diagnosed condition.
What Are The Signs and Symptoms of Brown-Sèquard syndrome?
The first symptoms of Brown-Sèquard syndrome that an individual may experience include loss of pain and temperature senses below the injured area. Loss of bladder and bowel control are also common initial symptoms.
Paralysis occurs on the side of the body where the trauma or injury took place and can begin immediately after the incident. Muscles in that area will begin deteriorating and weakening, and mobility will become impaired at some point. Muscles on the opposite side of the body will show symptoms after the initial injured area. This generally manifests in numbness, weakness, or loss of sensation.
If these signs and symptoms are not diagnosed immediately, the paralysis could become permanent and disabling. Additionally, untreated Brown-Sèquard syndrome can lead to alternate complications such as spinal shock, hypotension, and infections in the organs. These complications can become serious and life-threatening depending on the severity of the injury itself.
Causes of Brown-Sèquard Syndrome
While anyone who experiences an accident or trauma to the spine may end up being diagnosed with Brown-Sèquard syndrome, motor vehicle accidents account for the majority. Motor vehicle accidents cause 40% of cases of Brown-Sèquard syndrome, while 13% of cases are caused by slip and fall accidents. Therefore, over half of the number of individuals diagnosed with Brown-Sèquard syndrome obtain their injuries through severe trauma from an accident, which can happen to anyone at any time.
Situations that require significant acceleration and deceleration put an individual at risk for obtaining this injury. This is why motor vehicle accidents are a leading cause, as the forced motion from a vehicular collision is strong enough to cause sudden jolts from an immediate stop. Vehicles often travel at high speeds, and when those speeds are suddenly reduced to nothing without a gradual stop, the body is severely at risk and can be thrown easily from a place.
Penetrating trauma is also a known cause of Brown-Sèquard syndrome, particularly from stabbing, gunshot, or puncture wounds. These cases are not as common as accidents but have become synonymous with Brown-Séquard syndrome. This is due to the fact that penetrating trauma can reach one-half of the spinal cord directly and, therefore, is most likely to cause an injury in a particular area.
Non-traumatic conditions may also cause Brown-Sèquard syndrome, but this is less common. These types of conditions include herniated discs, multiple sclerosis, tumors, cancer treatments, or other types of diseases that could lead to physical consequences. It can also be caused by bacterial infections.
The Diagnosis
When a doctor or medical health professional diagnoses Brown-Sèquard syndrome, they first analyze the individual’s history, including neurological and trauma history and the details of the accident or injury. Medical history is important in the diagnosis as it determines the potential cause or contributing factors that have caused the injury.
A physical exam will be conducted, but this can sometimes be difficult as the individual is likely to still be in spinal shock immediately after an accident. The physical exam component will also include a neurological exam to identify the extent of any nerve damage within the body. In most cases, an MRI will be utilized to examine the damage to the spinal cord using medical imaging technology.
Brown-Sèquard syndrome can be difficult to diagnose due to its rare occurrence and the fact that it shares common symptoms with multiple neurological disorders. Therefore, the diagnosis of Brown-Sèquard syndrome relies significantly on the characterization of the paralysis on one side and sensory loss on the other side.
Is recovery from Brown-Sèquard Syndrome possible?
Generally, treatment will be performed to treat the specific cause of the individual’s Brown-Sèquard syndrome, such as repairing a lesion or fixing a herniated disc. The type of cause is determined by examining the individual’s history and the details of the accident to determine if this was the cause.
Recovery focuses on allowing individuals to regain their quality of life and utilize the tools and resources that would enable them to return to their regular activities. This may include pain management techniques alongside physical rehabilitation and therapy to increase movement capabilities.
Doctors may prescribe drugs to assist the individual in pain management and muscle control. In some cases, high-dose steroids have been provided for some patients, but the use of these particular drugs has been contested and has caused division within the medical profession.
Physical therapy is a critical component used in recovery from any type of spinal cord injury. Assistive devices such as wheelchairs, braces, splints, and other tools will be utilized alongside physical therapy to allow the individual to perform regular activities and develop a routine that can assist in regaining mobility control and function.
Ultimately, recovery from Brown-Sèquard syndrome is possible with proper treatment and attentive medical care. Statistics indicate that up to 90% of individuals who suffer from Brown-Sèquard syndrome can make a full recovery and regain mobility function. This may not amount to complete and full mobility function, but these individuals are generally able to gain control over their bladder, and enough leg strength to be able to walk again.
Contact our Hamilton spinal cord injury lawyers today.
Spinal cord injuries (SCI) are a severely debilitating neurological condition with tremendous socioeconomic impact on the affected individuals, their families and the health care system. If you or a loved one has suffered a spinal cord injury, it’s important that you retain the services of an experienced spinal cord injury lawyer sooner rather than later – as it’s important to ensure that proper funding is put in place by your insurance company (or an insurance company). Also, an experienced spinal cord injury lawyer will be able to assist with the projected evaluations over your life expectancy as to the care and rehabilitation you will require. Our Hamilton spinal cord injury lawyers work with the area’s top occupational therapists, physical therapists, recreational therapists, psychologists, neuropsychologists, developmental psychologists, audiologists, rehab specialists, nutritionists, behavioural speech therapists, attendant care providers, and vocational rehabilitation experts, among other areas.
At Lalande Personal Injury Lawyers, we take pride in being trusted Hamilton personal injury lawyers since 2003. Over the years, we’ve helped our clients recover more than $45 Million in settlements and verdicts in personal injury, disability, and employment law cases. Whether you’re dealing with a life-changing injury, a denied disability claim, wrongful death, a hurt child or employment termination, we are here to provide compassionate and experienced legal representation. If you believe you have a case, call us today—we’re ready to help you secure the compensation you deserve.
Call Lalande Personal Injury Lawyers today, no matter where you are in Ontario at 905-333-8888 for your free consultation. Alternatively, you can contact us online, confidentially, by filling out a contact form.
*This information has been obtained from our experience and knowledge of spinal cord injury law as well as Medical Peer Reviewed Journals and Medical Studies from SCIRE (Spinal Cord Injury Research Evidence)