AN INTERESTING CASE OF SPINAL CORD INJURY WITH BROWN SEQUARD PLUS FEATURES: A SILVER LINING IN THE CLOUD JUSTIFYING THE EFFORT TO RECOGNIZE THE RARE SYNDROME

Dr Jaydeep Nandi, Ms Snehanjali Jena

Abstract


BACK-GROUND : The incidence of traumatic spinal cord injury was estimated at 15 new cases per million per year in India with Brown Sequard
Syndrome comprising of 2- 4% of the injuries. [1,2] The prognosis is usually favourable.
CASE CHARECTERSTICS: An adolescent male with history of fall from tree leading to loss of consciousness immediately and loss of
movement and sensation in all the 4 limbs, reported to a Primary Health Centre. After giving IV Fluid and initial resuscitation, he gained his
consciousness but was unable to move his limbs. 2 days post injury he was referred to AIIMS RAIPUR with motor and sensory deficit in all his four
limbs. Clinically he appeared to be a case of BROWN SEQUARD PLUS SYNDROME or spinal hemiplegia (ASIA C) which has in general a
favourable prognosis of ambulation and independence in ADL. [3]
INTERVENTION- Corticosteroid, SOMI brace, physical therapy interventions.
OUTCOME- After 1 month of combined treatment patient showed dramatic improvement and became independent in ambulation and ADL.
MESSAGE- Brown sequard syndrome being an incomplete injury can result in very good PROGNOSIS if timely managed with proper intervention.


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References


Zhang XY, yong YM. Scissors stab wound to the cervical spinal cord at the cranio cervical junction .Spine J.2016 june 16(6)e403-6(pubmed).

Tseng ws, huang NC,Huang WS,Lee HC .BSS.a rare manifestation of decompression sickness.ocuo Med (land).2015 De;65(9) 758-60(pubmed)

Traumatic-jain NB,Ayens GD,Peterson EN,Harris MB ,Morse L ,O conn or KC,Garshick e.Traumatic spinal cord injury in the US ,1993-2012,JAMA.2015 JUNE 09;313(22);2236-43(PMC free article j(pubmed)

BRAAKMAN R.PENNING I..injuries of the cervical spinein;Vinken P.Bruyn, G .editors. Handbook of clinical neurology vol 25. Amsterdarn; North Holland publishing company ;1976;227-380

BOHLMAN HH.Acute fractures and dislocations of the cervical spine .An analysis of three hundred hospitalised patients and review of the literature .1 Bone joint surg 1979;61A;1119-42.

BOSCH A.STAUFFER ES.NICKEL VI.. Incomplete traumatic quadriplegia a ten near review.JAMA1971;216;473-8

LITTLE JW HALAR E.Temporal course of motor recovery after Brown sequred spinal cord injuries.paraplegia 1991;29;582-589.

ROTH E.PARK T .PANG T.YARKONY G,LEE M.Traumatic cervical BSS&BSPS; The spectrum of presentation and outcomes. Paraplegia 1991;29;582-589.

BOLLER F,Grafman j.Acalculia .in vinken pj,Bruyn GW,Klawans HL ,eds Hand book of clinical neurology .2nd ed .Amsterdon;North Holland ,1985,1;43

sstandards for neurological classification of spinal cord patients .American spinal injury association Chicago 1992.

Detre TP,Kupfer DJ. Psychiatric history &mental status examination ;in fredman A,Kaplan H,sadock B,eds .comprehensive textbook of psychiatry .Baltimore; willioms &Wilkins ,1975;1:724-35

CATZ A.ITZKOVICH M.TESIO I.BIERING –SORENSEN F.WEEKS C.LARA –MEE MT .ETAL .A multicenter international lstudy on the spinal cord independence measures,version 3; Rasch psychometric validation .spinal cord 2007 apr;45(4);275-91

PODOLSKY S.M ,Baraff L.J,simon R.R .etal .efficacy of cervical spine immobilisation method.j.trauma 1983.23;687-690

B Perrowin-verbe,jj labat,I Richard ,IM De La GRAVE –Spinal cord 1995-nature .com.

LUNDY –EKMAN L.spinal region in lundy –ekman L,ed –Neuroscience fundamentals for rehabilitation;3rd ed ;st .Lowis ,Mo-saunders Elsevier; 2007;322-323.

Shumway –cook A,wooll a COH NH,ed.Motor control.

Schmitz TJ.Locomotor training .In O Sullivan SB,Schmitz TJ,eds.physical Rehabilitation 5th ed .Philadelphia ,PA;F.A.Davis ;2007

Herr RD ,B arrett J.An unusual presentation of BSS.Ann emerg Med .1987,16;1285-1288(pubmed)

Lee HM ,Kim NH,Park CI .Spinal CI caused by a stab wound .a case report yonsei Med J.1990;31;280-284(pubmed)

MC Carron MO,Flynn PA ,Pang KA,Hawkins SA.Trauatic B SPS.Arch Neurol .2001;58;1470-1472(pubmed)

ROSS ED,Kirkpatrick JB ,Lastimasa A C.Position &vibration sensation ;functions of dorsal spinocerebellar tracts.Ann Neurol .1979;5 ;171-176.(pubmed)

Pollard ME,Apple DF .Factors associated with improved neurologic outcome in patient with incomplete tetraplegia .spine (phila pa 1976)2003;28;33-39(pubmed).


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