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Question answered:05/09/07 Warning! this question is over two years old.
It would appear that these are distinct entities. A comprehensive overview of Brown Sequard Syndrome has been published on eMedicine [1]. The review mentions multiple sclerosis, as a possible differential diagnosis and, reported here, as a cause:
“Numerous nontraumatic causes of Brown-Séquard syndrome have also been reported, including tumor (primary or metastatic), multiple sclerosis, disk herniation, herniation of the spinal cord through a dural defect (idiopathic or posttraumatic), epidural hematoma, vertebral artery dissection, transverse myelitis, radiation, type II decompression sickness, intravenous drug use, and tuberculosis.” NOTE: Our emphasis.
The same article gives the following definition of the syndrome:
“Brown-Séquard syndrome is defined as an incomplete lesion of the spinal cord characterized by ipsilateral upper motor neuron paralysis and loss of proprioception with contralateral loss of pain and temperature sensation. A zone of partial preservation or segmental ipsilateral lower motor neuron weakness and analgesia may be noted. Loss of ipsilateral autonomic function can result in Horner syndrome. As an incomplete spinal cord syndrome, the clinical presentation of Brown-Séquard syndrome may range from mild to severe neurologic deficit.
Brown-Séquard-plus syndrome is a term often used to describe less pure forms of the syndrome.”
It later reports, in the pathophysiology section:
“The pathophysiology of Brown-Séquard syndrome is damage or loss of ascending and descending spinal cord tracts on one side of the spinal cord. Spinal cord anatomy accounts for the clinical presentation. The motor fibers of the corticospinal tracts cross at the junction of the medulla and spinal cord. The ascending dorsal column carrying sensation of vibration and position runs ipsilateral to the roots of entry and crosses above the spinal cord in the medulla. The spinothalamic tracts convey sensations of pain, temperature, and crude touch from the contralateral side of the body. At the site of spinal cord injury (SCI), nerve roots and/or anterior horn cells also may be affected.”
Reference
1) http://www.emedicine.com/pmr/topic17.htm
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