How to get rid of Brown-Séquard syndrome? Effective elimination of Brown Secar syndrome Brown Secar syndrome at various levels.

The main symptoms of this syndrome are paralysis or paresis on the affected side. The disease is treatable, but recovery is not possible in all cases.

The reasons

As an independent disease, Brown-Séquard syndrome is rare. The provoking factors are:

spinal injuries and spinal cord. Bruises, dislocations and fractures are the main causes of Brown-Séquard syndrome.
Penetrating wounds, if they result in damage to the spinal cord.
Benign and malignant tumors bone or soft tissue.
Vascular damage and diseases that lead to impaired circulation of the spinal cord, for example, stroke, hematoma, abscess.
myelopathy, multiple sclerosis.
Radiation damage to the spinal cord.

The disease occurs in men and women, regardless of age.

Symptoms

Brown-Séquard syndrome is characterized by damage to neurons in only one half of the diameter of the spinal cord. But, despite this, the healthy part of the body also suffers, symptoms of neuralgia appear.

Sensitivity is lost, the patient does not feel touch and pain. On the healthy side, there are no sensations up to the level of damage; sensitivity is also partially lost directly at the level of the lesion.

Paresis or paralysis can be observed below the level of the lesion, so the higher the focus is, the more difficult the patient's health condition.

Symptoms depend on the degree of damage to the spinal cord. At first, the paralysis is flaccid, but then it becomes spastic.

The main signs that appear on the affected side:

paralysis below the level of the affected spinal cord;
decreased sensitivity (pain, tactile and temperature) or its complete loss;
redness of the skin in the affected area, the skin becomes cold to the touch;
trophic disorders, such as bedsores.

If the spinal cord is damaged at the level of the cervical vertebrae, then it paralyzes the arm and leg on the affected side. Things are a little better if the focus is in the lumbar region, then only the lower limbs are involved in the pathological process.

Classification

Depending on the cause that contributed to the appearance of the Brown-Sequard syndrome, the following types are distinguished:

tumor;
traumatic;
hematological;
infectious and inflammatory.

Brown-Sequard syndrome can have 3 variants of the course, respectively, its symptoms will be different. The classification is:

Classic variant. The symptoms are characteristic of this disease. The disease progresses without dangerous consequences and complications.
Inverted. The symptomatology is characteristic of the Brown-Séquard syndrome, only all the signs that appeared on the diseased side pass to the healthy part of the body.
Partial. Symptoms may be absent or mild and appear only in some parts of the body, for example, in the limbs.

The latter variant of the course of the disease can be found very rarely, more often the disease proceeds according to the classical variant.

Which doctor treats Brown-Séquard syndrome?

If symptoms of the disease occur, you should seek the advice of a neurologist. Further treatment may be performed by a surgeon.

Diagnostics

After the patient goes to the hospital, the doctor will take an anamnesis, check the reflexes and sensitivity of the limbs. The specialist can make an accurate diagnosis only after the examination data.

Instrumental diagnostic methods include:

X-ray of the spine - allows you to identify damage to the spine;
- makes it possible to detect changes not only in bone tissue, but also in blood vessels, muscles and nerve endings;
- the most informative method for studying damage to the spinal column and spinal cord.

Treatment

In the treatment of Brown-Sequard syndrome, it is important to establish the cause of the disease and eliminate it. If neuralgia is caused by a tumor or hematoma, first of all you need to get rid of them. Then the integrity of the spinal column is restored, the spinal cord and nerve endings are sutured.

Treatment of the disease is only surgical. The earlier the operation is performed, the less the chance of complications.

The purpose of surgical intervention is decompression, that is, the elimination of compression of the spinal cord, blood vessels and nerve endings. Doctors choose the type of operation based on the cause of the disease.

After eliminating the pathology that leads to compression, the patient is prescribed a course of rehabilitation. It consists of the following activities:

drug therapy(Phenobarbital, vitamin E, Amaridan, Ubretide, from puffiness - Glycerin, Magnitol, Furosemide, to normalize microcirculation in brain tissues - Cavinton, Dipyridamole, a nicotinic acid, for the prevention of thrombosis - Heparin);
physiotherapeutic procedures (paraffin applications, electrophoresis with iodine and potassium, ozocerite).

Without surgery, this complex will not bring relief to the patient.

Complications

Complications can be observed only if the recommendations of doctors are not followed or if you go to the hospital late. The consequences are:

strong;
chronic headaches, migraine;
hemorrhage in the spinal cord;
spinal shock;
rupture of the tissue of the spinal cord;
violation of the functioning of the pelvic organs.

Restriction of mobility, urinary incontinence, constipation, problems with potency can be added to constant back pain.

When an arteriovenous aneurysm ruptures, severe dagger pain occurs in the region of the spinal column.

Prevention

Since the complications of the disease are quite dangerous and can lead to loss of mobility, it is better to prevent the onset of the disease. It is necessary to monitor health, treat infectious and inflammatory diseases of the spinal column in time, do exercises daily, monitor posture, and keep your back straight.

Since Brown-Séquard syndrome often appears after serious injuries, such as those received as a result of an accident or a fall from a height, you need to follow safety measures while driving or working at height.

If damage to the spinal column could not be avoided, you should immediately consult a doctor, without waiting for a deterioration in well-being.

The prognosis for recovery largely depends on the patient. In most cases, it is favorable. The patient can move independently and do all the work. But only a timely appeal for medical care help prevent the progression of the disease.

Brown-Sekara Syndrome- a symptom complex observed with damage to half the diameter of the spinal cord: on the side of the lesion, central paralysis (or paresis) and loss of muscle-joint and vibration sensitivity are noted, on the opposite side - loss of pain and temperature sensitivity.

Code by international classification ICD-10 diseases:

The reasons

Etiology. Injuries and penetrating injuries of the spinal cord. Circulatory disorders of the spinal cord. Infectious and parainfectious myelopathy. Tumors of the spinal cord. Irradiation of the spinal cord. Multiple sclerosis (sclerosis).

Pathogenesis. Radicular and segmental disorders on the side of the injury. Conduction disturbances of the lesion level are lower.

Symptoms (signs)

Clinical picture. In the acute period - the phenomena of spinal shock (below the level of the lesion, complete flaccid paralysis and loss of all types of sensitivity are noted). Further developed: . Spastic paralysis (or paresis) and a disorder of deep sensitivity below the level of the lesion on the same side. On the opposite (healthy) side, there is a loss of pain and temperature sensitivity to the level of damage according to the conduction type. The development of flaccid paresis and segmental loss of sensitivity at the level of damage. Ataxia, paresthesia, radicular pain may occur.

Treatment

Treatment operational (decompression).

Synonyms. Hemiparaplegic syndrome. Half spinal cord syndrome

ICD-10. G83 Other paralytic syndromes

Brown - Sekara syndrome (Ch.E. Brown-Sequard, French physiologist and, 1817-1894)

combination clinical symptoms, developing with damage to half the diameter of the spinal cord. On the side of the lesion, there are spastic, conduction disorders of the deep (muscle-articular feeling, vibration sensitivity (Sensitivity) , feelings of pressure, weight, kinesthesia) and complex (two-dimensional, discriminatory, feelings of localization) sensitivity, sometimes (Ataxia) . At the level of the affected segment, radicular pain and the appearance of a narrow zone of analgesia and termanesthesia are possible. On the opposite side of the body, there is a decrease or loss of pain and temperature sensitivity, and the upper level of these disorders is determined several segments below the level of spinal cord injury.

With damage at the level of the cervical or lumbar thickening of the spinal cord, peripheral or paralysis of the muscles innervated on the affected anterior horns of the spinal cord (peripheral motor neuron) develops.

Brown-Sequard syndrome occurs with syringomyelia (Syringomyelia) , tumors of the spinal cord, hematomyelia, ischemic disorders of the spinal circulation, injury, contusion of the spinal cord, epidural hematoma, epiduritis, multiple sclerosis (multiple sclerosis), etc.

True half of the spinal cord is rarely observed. Most often, only a part of half of the spinal cord is affected - a partial variant, in which in B.-S. With. some of its constituent features are missing.

In the development of clinical variants of B.-S. With. play the role of a pathological process in the spinal cord (intra- or extramedullary), its course and features of the course, various afferent and efferent conductors of the spinal cord to compression and hypoxia, individual characteristics vascularization of the spinal cord, etc. The syndrome has a topical and diagnostic value. Localization of the lesion in the spinal cord is determined by the level of violations of surface sensitivity.

Bibliography: Bogorodinsky D.K. and Skoromets A.A. Spinal cord infarctions, p. 146, L., 1973; Collins R.D. nervous diseases, from English, p. 118, M., 1986.

1. Small medical encyclopedia. - M.: Medical Encyclopedia. 1991-96 2. First aid. - M.: Great Russian Encyclopedia. 1994 3. Encyclopedic Dictionary medical terms. - M.: Soviet Encyclopedia. - 1982-1984.

See what "Brown-Sekara syndrome" is in other dictionaries:

- (Ch. E. Brown Sequard, 1817 1894, French neuropathologists physiologist; syn. Syndrome of half spinal cord lesion) a symptom complex observed when half of the diameter of the spinal cord is damaged: on the side of the lesion there are central ... ... Big Medical Dictionary

Big Medical Dictionary

BROWN-SENAR SYNDROME- BROWN SENAR SYNDROME, described by him in 1849, is observed with unilateral lesions of the spinal cord and is characterized by the following symptoms: I. On the side of the lesion: 1) paralysis, first flaccid, then spastic; 2) muscle disorder ... ... Big Medical Encyclopedia

BROWNSECAR SYNDROME- honey. Brown Sekar's syndrome is a symptom complex observed when half of the diameter of the spinal cord is damaged: on the side of the lesion, central paralysis (or paresis) and loss of musculoskeletal and vibrational sensitivity are noted, on ... ... Disease Handbook

A neurological disease associated with impaired function of a number of segments of the spinal cord. In those areas of the body that are innervated by nerves extending from the affected area, there is marked muscle weakness and loss of skin ... ... medical terms

BROWNE-SECAR SYNDROME- (Brown Sequard syndrome) neurological disease associated with impaired function of a number of segments of the spinal cord. In those areas of the body that are innervated by nerves extending from the affected area, there is pronounced muscle weakness and ... ... Dictionary in medicine

See Brown Sekara Syndrome... Medical Encyclopedia

- (medulla spinalis) part of the central nervous system located in spinal canal. S. m. has the appearance of a strand white color, somewhat flattened from front to back in the area of thickenings and almost round in other departments. In the spinal canal ... ... Medical Encyclopedia

- (synonymous with spinal circulation) It has been established that several upper cervical segments of the spinal cord supply blood to the anterior and posterior spinal arteries, which branch off from the vertebral arteries. Segments below segments CIII CIV, ... ... Medical Encyclopedia

- (meninges) connective tissue structures covering the brain and spinal cord. There are hard shell (dura mater, pachymeninx), arachnoid (arachnoidea) and vascular, or soft (vasculosa, pia mater). The arachnoid and soft shells are combined ... ... Medical Encyclopedia

The system of efferent neurons, whose bodies are located in the cerebral cortex, ends in the motor nuclei cranial nerves and gray matter of the spinal cord. As part of the pyramidal path (tractus pyramidalis), cortical nuclear fibers are isolated ... ... Medical Encyclopedia

In which half of its diameter is affected, it is customary to call the Brown-Séquard syndrome. The pathological process is quite rare. Among diseases of the central nervous system, it occupies no more than 1-2%. The disease is named after the French neuropathologist and physiologist who first described the symptom complex at the end of the 19th century.

Classification

Violations in the area of influence of an unfavorable factor cause focal and radicular symptoms

The syndrome in its classic version, studied by the neurologist Charles Brown-Séquard, is rare. Usually the disease proceeds according to an alternative variant that differs from the classical course. clinical manifestations. Depending on the symptoms of pathology, there are:

classic syndrome - the course of the disease is fully consistent with the traditional description;
inverted syndrome - classic symptoms appear on the opposite side of the body;
partial syndrome - some symptoms are absent or appear in areas of the body that do not correspond to the classical description.

Brown-Séquard syndrome can be caused by various adverse factors. Depending on the cause that influenced the onset of the disease, there are:

traumatic syndrome;
tumor syndrome;
hematogenous syndrome;
infectious-inflammatory syndrome.

Classification of the disease helps to correctly prescribe treatment and manage dispensary observation after the end of therapy.

The reasons

The disease causes damage to the neurons of one half of the diameter of the spinal cord. The other half continues to function normally, however, neurological symptoms may also appear in this area.

Lead to the development of pathology:

injuries of the spinal column with damage to the tissue of the spinal cord (traffic accidents, falling on the back from a height, stab and gunshot wounds in the spine);
tumors from the tissue of the spinal cord and bone structures of the spine of a benign or malignant nature (sarcomas, neurinomas, gliomas, meningiomas);
violation of blood flow through the spinal vessels (epidural hematoma, spinal hemangioma, spinal cord stroke);
infectious and inflammatory myelopathy;
multiple sclerosis;
abscesses, phlegmon in the spine;
shell shock and radiation exposure spinal cord.

Location of sensory and motor pathways in the spinal cord

Typically, Brown-Séquard syndrome develops as a result of road accidents, penetrating knife and gunshot wounds, tumor formations in the spinal cord.

Clinical picture

The disease is a neurological symptom complex - a set of symptoms, the nature of which depends on the level of damage to the spinal cord and the amount of altered nervous tissue.

Often, not the entire half of the diameter of the spinal cord is involved in the pathological process, but only certain areas with predominant localization in the anterior or posterior horns.

The classical variant of the disease is manifested by a complex neurological symptoms.

On the affected side of the spinal cord:

below the level of damage to the nervous tissue, at the beginning of the disease, flaccid, and then spastic paralysis or paresis develops - increased muscle tone, which makes motor activity difficult and causes pain;
decrease in deep types of sensitivity - muscular-articular, vibrational, temperature, sensation of body weight;
vegetative-trophic disorders - vasodilation leads to reddening of skin areas, while the skin is cold to the touch, the formation trophic ulcers and bedsores.

On the healthy side of the spinal cord:

below the level of damage to the nervous tissue, superficial types of sensitivity decrease - tactile (touch) and pain;
at the level of damage to the nervous tissue, a partial loss of sensitivity is noted.

It should be remembered that below the level of compression (squeezing) of the spinal cord neurological disorders occur according to the conductive type, and at the level of exposure to the traumatic factor - according to the radicular and segmental type.

A change in superficial types of sensitivity on the healthy side of the spinal cord occurs as a result of the crossing of sensory fibers of this type with their transition to the opposite side. At the same time, motor fibers and nerve pathways of deep sensitivity in the spinal cord do not cross.

The syndrome causes pain in the area of damage, impaired motor functions and sensitive areas

The inverted variant of the disease differs from the classical manifestation of pathology.

On the affected side, sensitivity is reduced or absent, mainly of the deep type.
On the opposite side, motor disturbances occur in the form of paresis and paralysis, tactile, temperature sensitivity is reduced or absent, and the sensation of pain is disturbed.

The partial variant of the disease also has its own characteristics.

Disturbances in motor activity on the side of spinal cord injury are observed along the front or back surface of the body.
Lack of sensitivity develops in the same parts of the body where movement disorders appear.

The clinical manifestations of Brown-Séquard syndrome depend on the level of spinal cord injury. The higher the focus of the disease, the more areas of the body are susceptible to pathological changes. Thus, damage to the nervous tissue at the level of the cervical and first thoracic segments causes paralysis of the arms and legs of one half of the body, lack of sensitivity of these limbs and torso. Damage at the level of the lower thoracic and lumbar segments contributes to paralysis of the leg and impaired sensitivity of the lumbar region, buttocks, skin and muscles lower limb.

With a severe course of the disease and untimely therapy, complications develop:

pain syndrome of high intensity in the back, chronic headaches;
violation of the functioning of organs located in the small pelvis (constipation, impotence, incontinence of feces and urine);
hemorrhage in the tissue of the spinal cord;
functional rupture of the spinal cord;

Surgery is the only effective method disease therapy

Timely seeking medical help prevents the progression of pathology and the development of undesirable consequences.

Diagnosis and treatment

Upon initial contact with medical institution the neuropathologist collects the patient's complaints, finds out when the symptoms of the disease appeared and identifies the factors that provoke the disease. The specialist examines the patient, checks neurological reflexes, assesses the degree of violation of sensitivity and motor activity of the affected part of the body. To confirm the diagnosis of Brown-Séquard syndrome, prescribe instrumental methods examinations.

1X-ray of the spine in frontal and lateral projection helps to detect defects of the vertebrae and suggest damage to the tissue of the spinal cord.
2 Computed tomography (CT) allows you to detect changes not only in bone tissue, but also in the anatomical structures of the spinal cord, blood vessels, muscles, and nerve roots.
3Magnetic resonance imaging (MRI) – highly informative method with a layer-by-layer study of the area of damage to the spinal cord and spinal column, the identification of disorders in bone structures and soft tissues.

Detection of compression of the spinal cord tissue during tomography

Treatment of the disease is carried out surgically. With the help of the operation, compression of the spinal cord by bone fragments of the vertebrae, hematomas, abscesses, neoplasms is eliminated, and normal blood flow is restored in the area of pathology. If necessary, plastic surgery of the spine is performed. AT recovery period prescribe physiotherapy (ultrasound, UHF, diadynamic currents) and physiotherapy exercises to normalize metabolic processes, activate blood circulation, strengthen the muscular frame of the back.

Brown-Séquard syndrome is a rare neurological disease caused by damage to one half of the spinal cord. The pathological process proceeds according to different clinical options that differ in neurological manifestations. The disease is far from always amenable to a complete cure, but with a timely operation, it is possible to prevent the development of complications and improve the quality of life.

Brown-Séquard syndrome is a complex of symptoms of a complex disease of the central nervous system, in which the spinal cord is damaged. The vital functions of the central nervous system are impaired. The disease can manifest itself in different ways, men and women are equally susceptible to it.

This pathology was first described in 1849 by Charles Edouard Brown-Séquard, a French neurologist, after whom this rare disease is named. The characteristic symptoms and consequences of this disease were determined in detail.

Features of the pathology

The disease affects half the diameter of the spinal cord, leading to irreversible consequences in the body. Brown-Séquard syndrome manifests itself at different levels of the spine. The peculiarity of the course of the disease is that violations are detected on the side where there is damage, while the healthy half of the body continues to function normally. This is a classic version of the development of the syndrome. However, the disease has several varieties that differ in the features of the manifestation of symptoms. In this case, a healthy part of the body can also suffer. It is important to make a correct and timely diagnosis.

Classification and characteristic symptoms

In neurology, Brown-Séquard syndrome is rarely found in its classical interpretation, described by a French neurologist. The disease can have varieties. Each of them is characterized by its own set of clinical signs.

In medical science, the following systematization has been adopted:

Classic Syndrome

The clinical picture of the pathological process in the central nervous system corresponds to the characteristics adopted in the scientific version.

The symptomatology of this type of syndrome is described in domestic and foreign scientific works. On the side where the inflammatory process occurs, the following symptoms occur:

Paralysis (paresis), developing gradually. An increase in muscle tone leads to difficulty in movement and severe pain.
Decreased sensitivity of all levels up to the loss of a sense of one's own weight.
Redness skin due to vasodilation.
The appearance of bedsores and ulcers with prolonged immobility of body parts.

The healthy part of the body also undergoes changes:

Reduced pain and tactile sensitivity on the skin surface.
There may be a partial loss of sensation.

Inverted syndrome (reverse)

Symptoms affect the opposite side. The affected part of the body completely loses sensitivity. The opposite side is also devoid of sensitivity: tactile sensations disappear, temperature susceptibility and pain sensation are disturbed.

Partial syndrome (incomplete)

Symptoms may not be, or they appear in places that are not characteristic of the classical variant of the course of the disease. Violation of motor activity and the occurrence of paralysis and paresis occurs on the surface of the body from the front or back side. Motor dysfunction is accompanied by loss of sensation.

Subbulbar Opalsky Syndrome

Pathology affects the spinal cord at the level where the vertebrae are located cervical spine.

Cross paralysis of the limbs (leg - on the healthy half of the body, arm - on the side where the pathological process takes place).
Loss of superficial sensitivity on the face from the development of pathology.
Visual impairment ( upper eyelids descend, pupils dilate, eyeball sinks).

Causes of the anomaly

The disease occurs when compression of the spinal cord occurs, accompanied by a change in the structure of the spine, in particular the vertebrae in a certain part of it.

Among the reasons that can lead to the appearance inflammatory process in the spinal cord in its transverse section, the following are of particular importance:

mechanical injuries in the back (various injuries, fracture of the vertebrae);
tumor neoplasms that compress and displace the spinal cord;
inflammatory processes in the spinal tissues;
concussion and radiation of the spinal cord;
pathological formation of cavities in the spinal cord (syringomyelia);
multiple sclerosis;
inflammation of the loose connective tissue of the epidural space of the brain;
violation of blood circulation in the arteries of the brain.

The most common causes of the disease are dislocations, bruises in the spine, as well as injuries resulting from road traffic accidents and falling from a height.

Risk factors include severe physical activity and long-term sports. Often the syndrome develops in professional athletes.

Disease detection methods

To identify Brown-Sekarovsky syndrome, a specialist needs to examine the patient; check his neurological reflexes, sensitivity; determine if there are motor dysfunctions in the painful part of the body. If a syndrome is suspected and to determine the exact cause of its occurrence, more informative diagnostic methods are used. They allow you to detail the existing injuries in the spine and spinal cord and to consider in more detail the features of the course of the disease.

Therapeutic measures

Treatment of Brown-Séquard syndrome is aimed at eliminating the cause that caused this disease, as well as to restore the damaged part of the spine. The patient needs to be hospitalized in a neurological or neurosurgical department for the operation. If the disease is caused external factors, decompression treatment is required. It involves the removal of formations that lead to compression of the spinal cord. Depending on the location and type of compression, posterior or anterior decompression is performed.

To improve the process of blood supply to the spinal cord, drug therapy is used (Kurantil, Cavinton, Heparin, etc.).

To eliminate swelling in the damaged section of the spinal cord and nearby areas, drugs such as Glycerin, Furosemide, Mannitol, etc. are used.

When diagnosing syringomyelia, when cavities form in the spinal cord as a result of compression, surgery turns out to be ineffective. This progressive disease of a chronic nature is congenital, and it is not possible to get rid of it.

Physiotherapy methods, special massage, physiotherapy exercises are used to accelerate the process of restoration of spinal cord tissue cells.

During the rehabilitation period, it is important to follow a special diet, limit the use of fatty foods, smoked meats, sweets.

It is necessary to treat Brown-Sequard syndrome under the close supervision of a doctor in compliance with all recommendations. Usage folk remedies unacceptable. Before taking medicines It is important to read the instructions for contraindications and side effects.