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Rare Case of Brown-Sèquard Syndrome From Cervical Disc Herniation

Although rare, a herniated disc can cause paralysis on one side of the body. The condition is called the Brown-Séquard syndrome. This is a case report of such an incident. Only 25 total cases have ever been reported.

The Brown-Séquard syndrome was first described by Dr. Charles E. Brown-Séquard back in the 1840s. It's caused by compression of one side of the spinal cord. The affected individual develops paralysis on one side of the body with pain and loss of sensation on the other side of the body. The symptoms develop as a result of the pressure placed on a specific area of the spinal cord.

In this case, an otherwise healthy 46-year old man developed symptoms of Brown-Séquard syndrome. A CT scan and an MRI were done showing a large disc herniation in the cervical (neck) spine. The entire left side of the spinal cord was impinged by the disc material.

The patient had neck pain, left arm numbness and weakness, right upper leg weakness, and decreased sensation on the right side of the chest and belly. Since there was no known trauma, arthritis, or history to explain the symptoms, the imaging tests were done.

Microsurgery was done immediately to remove the disc and fuse the spinal segment. The patient was put in a rigid cervical collar called a Philadelphia collar for eight weeks. Results were good with elimination of pain and restoration of sensory function. At the end of a month, there was still some mild motor loss present in the left arm and leg.

This case report demonstrated the importance of a rapid diagnosis and treatment when unusual neurologic symptoms develop. MRI was very instrumental in making the diagnosis quickly. Spinal cord decompression gave favorable results. Although the problem is rare, surgeons should be aware that central disc protrusion in the cervical spine is a possible cause of Brown-Séquard syndrome.


Faisal T. Sayer, MD, et al. Brown-Sèquard Syndrome Produced by C3-C4 Cervical Disc Herniation. In Spine. April 20, 2008. Vol. 33. No. 9. Pp. E279-E282.

05/15/2008

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