Brown-Sequard syndrome below the level of injury produces which deficit pattern?

• A. Ipsilateral loss of touch, proprioception, and motor; contralateral loss of pain and temperature.
• B. Bilateral loss of touch and proprioception.
• C. Ipsilateral loss of pain and temperature only.
• D. Contralateral loss of motor function and coordination.

Answer: (A)

Brown-Sequard syndrome results from a hemisection of the spinal cord, so the pathways on the injured side are affected differently than those on the opposite side. The dorsal columns and the corticospinal tract run mostly ipsilaterally below the lesion, so losing them produces loss of fine touch, vibration and proprioception, along with motor weakness or paralysis on the same side below the injury. The spinothalamic tract carries pain and temperature fibers that cross to the opposite side shortly after entering the cord; after crossing, they track contralaterally, so pain and temperature loss appears on the side opposite the injury below the lesion. Put together, the pattern below the level of injury is ipsilateral loss of touch, proprioception, and motor function, with contralateral loss of pain and temperature.