The treatment of Brown-Sequard syndrome is directed at the pathology causing the paralysis. If it is because of trauma, it should be dealt with on an emergent basis.
Brown-Sequard syndrome (BSS) is a rare neurological condition characterized by a lesion in the spinal cord which results in weakness or paralysis (hemiparaplegia) on one side of the body and a loss of sensation (hemianesthesia) on the opposite side.
The causes of Brown-Sequard syndrome are trauma, neoplasia (spinal cord tumour), multiple sclerosis, degenerative (herniation of discs and cervical spondylosis), cysts, cystic diseases, idiopathic spinal cord herniation, haemorrhage and ischaemia. One can get the syndrome through infections too; the infectious causes are meningitis, empyema, herpes zoster, tuberculosis and syphilis.
Other causes of this syndrome include gnathostomiasis and tropical spastic paraplegia (HTLV-1). Rollercoaster riding and chiropractic manipulation may sometimes contribute as the cause.
The treatment for Brown-Sequard syndrome (BSS) focuses on the underlying cause of the disorder. Usually the early treatment involves high-dose of steroids that may be beneficial in many cases.
Initially, a neurological examination is performed to establish the level of injury. Thereafter, careful cervical spine/dorsal spine immobilisation is necessary. The cases such as spinal cord herniation are important to identify as surgical intervention can improve prognosis by a great extent.
There are several early and late complications associated with spinal injury that may occur. The complications related to Brown-Sequard syndrome include hypotension (spinal shock), pulmonary embolism (prophylaxis needed), lung infection and depression.
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