What is Brown-S quard syndrome?

The spine is composed of vertebrae, which are a collection of interlocking bones. The soft tissue that lies between each vertebra is called a spinal disc.

In addition to providing flexibility between the vertebrae and supporting the spine, the discs also prevent the bones from grinding against each other. Furthermore, they act as shock absorbers to protect objects from damage when in motion.

Each disc has an inside which is soft, filled with gel. The shell outside is very hard, and it becomes stiff and loses its suppleness as it ages.

A bulging disc occurs when a tear in the outer or the part of the annulus of the disc leads to the eruption of the inner, jelly-like part of the discs between the bones of the spine.

In addition, when older, it tends to degenerate, flatten and bulge outward. Bulging disc will often compress, touch or damage the nerve resulting in pain.

A bulging disc is also usually found on the base of the lumbar spine. Occasionally the outer shell degenerates and tears releasing the gel core, which squeezes out into the hole in the wall.

Who is affected by Brown-S quard syndrome?

Although it is a rare condition, anyone can be afflicted with Brown-S quard syndrome. Those who are assigned female at birth and those who are assigned male at birth are equally affected.

What are the symptoms of Brown-S quard syndrome?

Brown-S quard syndrome (BSS) symptoms normally arise after suffering an injury that causes damage only on one side of the cord in a certain part of your spine.

In general, most patients with BSS first develop these symptoms:

• Loss of voluntary motor function, or muscle movement, on the side of your body affected by the area of the spinal cord damage lying below the site of the damage. This loss can be represented as paralysis or weakness.
• Loss of pain, temperature sense; and paralysis at the same level as the injury.

If a person with Brown-S quard syndrome received an injury to the right side of their spinal cord in their middle back, they would lose muscle movement in the right hip, leg, and foot muscles from mid-back down. They would lose their feeling of pain and temperature on the left side of their body from the middle back down but continue to be in control of the muscles on this side. This damage would not affect their head, neck, shoulders, and arms; everything would function perfectly.

Further conditions of BSS include the following:

• They may not be in control of the bowels and bladder, thereby experiencing faecal and urine
• Muscular atrophy and weakness in the affected area.

BSS symptoms vary from mild to severe. When BSS is treated appropriately, they usually recover.

What are the most common causes of Brown-S quard syndrome?

The most common causes of Brown-S quard syndrome (BSS) are traumatic lesions to the spinal cord, which are caused by:

• Gunshot wounds.
• Stab wounds.
• Car accidents.
• Blunt trauma.
• Fracture of the spine resulting from a trauma, such as a fall.
• It's important that you seek emergency treatment at the nearest hospital as soon as possible if you suffer any of these injuries.

Other, less common causes of BSS resulting from non-traumatic etiologies include:

• Cervical spondylosis of the neck
• Decompression disease
• Disc rupture
• Meningitis
• Ms means multiple sclerosis.
• Exposure to radiation
• Ischaemia or spinal blockage of blood vessel
• Tumours of spine
• Myelitis transverse
• Tuberculosis (TB)

How do you make the diagnosis for Brown-S quard syndrome?

If your physician suspects you to have BSS, they would proceed to the following:

• Performed complete history and general medical examination
• Carry out complete neurological evaluation through adequate assessment of all motor functions along with senses.
• Complete enquiry about any of your antecedent injuries and neurological, systemic diseases.

Your provider will then prescribe specific tests to confirm the diagnosis or rule out other potential reasons for your symptoms. These include an MRI scan.

What tests will be conducted to diagnose Brown-S quard syndrome?

Your doctor will likely to perform the following tests if your doctor suspects Brown-S quard syndrome in you:

• Magnetic resonance imaging (MRI): In the process of MRI, a painless procedure using a big magnet, radio waves, and a computer creates extremely clear images of the organs and structures inside your body. For BSS, MRI is the most helpful imaging test because it can be used to evaluate non-traumatic causes and detect structural damage in your spine.
• Myelogram and computed tomography (CT) of your spine: Your doctor will probably recommend an immediate myelogram and then a CT scan of your spine, if you cannot undergo an MRI. These tests might show damage to the nerve tissue on one side of your spinal cord. A myelogram is an imaging technique that views the interaction between the vertebrae and discs in your spinal column through your spinal cord, nerves, and nerve roots. A CT scan creates fine-grained images of the internal structures of your body using computers and X-rays.
• Blood tests: If the cause of your BSS is unknown, your doctor may prescribe specific blood tests to search for an infection that could be the source of your BSS.
• Lumbar puncture (spinal tap): Your doctor may perform a lumbar puncture to obtain a sample of cerebrospinal fluid (CSF) for examination if they suspect that multiple sclerosis, transverse myelitis, or tuberculosis are the causes of BSS. CSF is the clear fluid that surrounds your brain and spine.

How is Brown-S quard syndrome treated?

However, goals of treatment for all therapy are to maintain motor and sensory function and minimize consequences, depending on the cause of Brown-S quard syndrome. For the restoration of motor, substantial dosages of steroids (methylprednisolone) are administered very early as part of the treatment within eight hours of the damage. It can't be applied in all circumstances since it increases the risk of infection, especially if the cause is an infectious etiology or there's penetration damage. Management for Brown-S quard syndrome is mainly subdivided into two phases:

Supportive and symptomatic management: This includes, among others, the following:

• Anti-clotting blood thinners to inhibit clot formation in the blood vessels
• If possible, surgery for decongestion of spinal pressure
• Skincare for pressure ulcer prevention
• Insertion of a feeding (gastrostomy) tube to provide nutrition as the muscles of the gut may be flaccid
• Assistance with breathing if required
• Assistance with the bowel and bladder, including a urinary catheter, suppositories, or stool softeners, to manage constipation and incontinence.
• Medications if there are fluctuations in blood pressure and cardiac medications
• Medications for neuropathic pain
• As patients with Brown-S quard syndrome lack sensation to temperature, temperature-control blankets

Physical and occupational therapy can help reduce pain, increase mobility, preserve joint range of motion and muscular strength, prevent skin deterioration through appropriate positioning and frequent weight shifting, and teach you new or adaptable ways to carry out everyday tasks. Additionally, you could need a wheelchair, hand splints, braces, or limb supports.

Is it possible to prevent Brown-S quard syndrome?

The only way to prevent Brown-S quard syndrome is to make efforts to prevent spinal cord injuries by following simple safety measures such as road and traffic safety.

What is the prognosis or outlook for Brown-S quard syndrome?

There are many factors that determine the prognosis (outlook) of Brown-S quard syndrome (BSS), including the cause and degree of spinal cord injury.

However, the outlook for BSS is generally favorable. Walking is one of the functions that a person with BSS has an excellent chance to regain. Recovery, however is gradual. During the first three to six months after the onset of the illness, it decreases in pace; however, continuous neurological recovery might take up to two years.

What are the possible complications of Brown-S quard syndrome?

If left untreated, Brown-S quard syndrome can cause the following problems:

• Abdominal distension.
• Depression.
• Hypotension
• A pulmonary embolism is a blood clot in the lung.
• Infections, especially of the urinary tract and lungs.
• Irreversible paralysis.

When should I see my doctor about Brown-S quard syndrome?

Call your local emergency facility immediately if you suddenly feel numb on one side of your body or feel weak or paralyzed.

You will need to see your healthcare team frequently if you have been diagnosed with Brown-S quard syndrome in order to ensure that your spinal cord injury is healing appropriately. You guarantee the finest and quickest recovery possible by attending all of your physical and occupational therapy visits.

Why Tender Palm Super-Speciality Hospital for Brown-S quard syndrome?

Tender Palm Hospital, owned by doctors, is renowned for attracting the most experienced professional in the country. With the finest neurologist and neurosurgeons specialized in Brown-S quard syndrome. Tender Palm stands out as the premier Neurology hospital in Lucknow, India. Boasting cutting-edge infrastructure and advanced technology, Tender Palm ensures top-notch medical care for its patients.

To seek an expert consultation for any Neurology condition

Call us at +91-9076972161
Email at care@tenderpalm.com

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