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Case Report
Functional recovery in Brown-Séquard plus syndrome: A case report
1 Medical Student, Howard University College of Medicine, 520 W St NW, Washington, DC, USA
2 Orthopedic Surgery Resident, Howard University Hospital, 2041 Georgia Ave, Washington, DC, USA
3 Chief, Division of Neurosurgery, Department of Surgery, Howard University Hospital, 2041 Georgia Ave, Washington, DC, USA
Address correspondence to:
Damirez Fossett
Chief, Division of Neurosurgery, Department of Surgery, Howard University Hospital, 2041 Georgia Ave, Suite 5b-47A, Washington, DC 20060,
USA
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Article ID: 100107Z12DR2022
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Rush D, Goins K, Doe K, Fossett D. Functional recovery in Brown-Séquard plus syndrome: A case report. J Case Rep Images Surg 2022;8(2):15–20.ABSTRACT
Introduction: Brown-Séquard syndrome (BSS) is a rare neurological condition characterized by hemiplegia and hemianesthesia. It occurs as the sequelae to a hemi-transection of the spinal cord, and constitutes an incomplete spinal cord injury. We report a case of presumed BSS that resulted from a stab wound to the thoracic spine.
Case Report: A 64-year-old male presented to Howard University Hospital with complaints of back pain and loss of left lower extremity motor function. Neurological examination revealed weakness in the L2 through S1 nerve root distributions in the left lower extremity and hypoesthesia along the L2 through S1 dermatomal distributions in the right lower extremity. Imaging disclosed a foreign body extending from the muscle layer through the T6–T7 disc space. The patient was treated operatively with removal of a knife blade; the handle of which had been broken off at the surface of the skin. Post-operatively, prior to his discharge to an acute rehabilitation center, the patient’s motor symptoms improved while his sensory symptoms worsened. He was lost to follow-up for approximately six months and returned with a debilitating spastic paraparesis.
Conclusion: The presenting symptoms of BSS are not always uniform, and thus may constitute a Brown-Séquard plus syndrome (BSPS). Surgical intervention is rare; however, it may occasionally be necessary in the setting of penetrating trauma. Long-term functional recovery for BSS as documented in the literature is variable. With aggressive physical therapy and rehabilitation, a good outcome is attainable. The functional outcome of BSPS, however, may not be as favorable.
Keywords: Brown-Séquard syndrome, Brown-Séquard plus syndrome, Functional recovery, Surgical management
SUPPORTING INFORMATION
Author Contributions
Deja Rush - Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Karnesha Goins - Acquisition of data, Analysis of data, Drafting the article, Final approval of the version to be published
Keli Doe - Acquisition of data, Analysis of data, Drafting the article, Final approval of the version to be published
Damirez Fossett - Substantial contributions to conception and design, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2022 Deja Rush et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
