Brown-Sèquard syndrome produced by C3-C4 cervical disc herniation: a case report and review of the literature

• Published in: Spine (Philadelphia, Pa. 1976) Vol. 33; no. 9; pp. E279 - E282
• Main Authors: Sayer, Faisal T, Vitali, Aleksander M, Low, Hu Liang, Paquette, Scott, Honey, Christopher R
• Format: Journal Article
• Language: English
• Published: United States 20-04-2008
• Subjects: Bone Transplantation; Brown-Sequard Syndrome - etiology; Brown-Sequard Syndrome - pathology; Brown-Sequard Syndrome - surgery; Cervical Vertebrae; Decompression, Surgical; Diskectomy; Humans; Ilium - transplantation; Intervertebral Disc Displacement - complications; Intervertebral Disc Displacement - diagnosis; Intervertebral Disc Displacement - surgery; Magnetic Resonance Imaging; Male; Middle Aged; Spinal Cord Compression - complications; Spinal Cord Compression - etiology; Spinal Cord Compression - pathology; Spinal Cord Compression - surgery; Spinal Fusion; Treatment Outcome
• ISSN: 0362-2436; 1528-1159
• DOI: 10.1097/BRS.0b013e31816c835d

The article presents a case in which Brown-Sèquard syndrome resulted from a painless C3-C4 disc herniation.
To raise spinal surgeons' awareness of this unusual clinical problem.
Brown-Sèquard syndrome involves ipsilateral loss of motor function combined with contralateral loss of pain and temperature sensation. Brown-Sèquard syndrome is commonly seen in the setting of spinal trauma or an extramedullary spinal neoplasm, but rarely it can be caused by a herniated cervical disc.
A 46-year-old man presented with progressive numbness and weakness in the left arm, mild neck pain, and reduced temperature sensation on the right side of the body. There was weakness in left arm and leg and proximal right lower limb. Magnetic resonance imaging showed large C3-C4 disc herniation compressing the spinal cord at that level. Anterior cervical discectomy and fusion with iliac crest bone graft was performed.
Follow-up showed complete resolution of the neck pain, normal sensory function, and complete recovery of motor power in the left upper and right lower limb. There was a slight residual weakness in the left leg.
Brown-Sèquard syndrome is rarely caused by a cervical disc herniation. This etiology may be underdiagnosed but has a more favorable outcome in those cases where rapid diagnosis is followed by spinal cord decompression.