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