About spastic spinal monoplegia syndrome

What is spastic spinal monoplegia syndrome?

Brown-Séquard syndrome is a rare spinal disorder that results from an injury to one side of the spinal cord in which the spinal cord is damaged but is not severed completely. It is usually caused by an injury to the spine in the region of the neck or back. In many cases, affected individuals have received some type of puncture wound in the neck or in the back that damages the spine and causes symptoms to appear.


Characteristically, the affected person loses the sense of touch, vibrations and/or position in three dimensions below the level of the injury (hemiparalysis or asymmetric paresis). The sensory loss is particularly strong on the same side (ipsilateral) as the injury to the spine. These sensations are accompanied by a loss of the sense of pain and of temperature (hypalgesia) on the side of the body opposite (contralateral) to the side at which the injury was sustained.

What are the symptoms for spastic spinal monoplegia syndrome?

Symptoms of Brown-Séquard syndrome usually appear after an affected individual experiences a trauma to the neck or back. First symptoms are usually loss of the sensations of Pain and temperature, often below the area of the trauma. There may also be loss of bladder and bowel control. Weakness and Degeneration (atrophy) of muscles in the affected area may occur. Paralysis on the same side as that of the wound often occurs. Paralysis may be permanent if diagnosis is delayed.

Individuals with this syndrome have a good chance of recovering a large measure of function. More than 90% of affected individuals recover bladder and bowel control, and the ability to walk. Most affected individuals regain some strength in their legs and most will regain functional walking ability.

What are the causes for spastic spinal monoplegia syndrome?

This syndrome is often a consequence of a traumatic injury by a knife or gunshot to the spine or neck. In many cases, however, it is caused by, or is the result of, other spinal disorders such as cervical spondylosis, arachnoid cyst or epidural hematomas. Brown-Séquard syndrome may also accompany bacterial or viral infections. Blunt traumas, such as occur in a fall or automobile accident, on rare occasions may be the cause of the Brown-Séquard syndrome.

The medical literature cites, as causing or being associated with BSS, the following conditions: lateral curvature of the spine (kyphosis), Chiari I malformation, methamphetamine injection in the neck, multiple sclerosis, spinal epidural hematoma, intramedullary spinal cord tumor, and myeloschisis. Among the infectious or inflammatory causes cited are: meningitis, empyema, herpes zoster, herpes simplex, myelitis, and tuberculosis.

What are the treatments for spastic spinal monoplegia syndrome?

There is no specific treatment for individuals with Brown-Séquard syndrome. In most instances, treatment focuses on the underlying cause of the disorder. Treatment may involve drugs that control muscle symptoms, and there is some dispute as to whether high-dose steroid administration is effective.

Devices that help an affected individual continue daily activities such as braces, hand splits, limb supports, or a wheelchair are important. Various other aids may be necessary if the patient has difficulty breathing or swallowing. Other treatment is symptomatic and supportive.

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