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J Acupunct Res > Volume 32(1); 2015 > Article
Kim, Kim, Park, Choi, and Cho: A Case Report of Brown-Sequard Syndrome Caused by Traumatic Cervical Fracture
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Abstract

Objectives:

The purpose of this study is to report a case of Brown-Sequard syndrome caused by traumatic cervical fracture, presenting pain in the right upper extremity and back of the left hand, motor weakness in the right side and diminished pain and temperature in the left side.

Methods:

A patient received Korean medical treatment(acupuncture, electroacupuncture, herbal medicine, cupping, moxibustion, Silver Spike point electrotherapy(SSP)) and rehabilitation treatment. We evaluated pain with the Numeric Rating Scale(NRS), motor grade with a Medical Research Council(MRC) scale, sensory function and Modified Barthel Index(MBI).

Results:

After treatment, the patient showed considerable improvement in NRS, motor & sensory function, and MBI.

Conclusions:

Korean medical and rehabilitation treatments could be effective for Brown-Sequard syndrome patients. More extensive studies should be carried out.

Fig. 1.
Pre OP state of C-spine MRI saggital view
acupunct-32-1-133f1.gif
Fig. 2.
Pre OP state of C-spine MRI axial view
acupunct-32-1-133f2.gif
Fig. 3.
Post OP state of C-spine X-ray
acupunct-32-1-133f3.gif
Table 1.
Motor Grade of Rt. Upper/ Lower Extremity at Admission
Shoulder Flex. 3
Ext. 3+
Abd. 3
Add 3+

Elbow Flex. 3+
Ext. 2−

Wrist Flex. 2−
Ext. 3+

Finger Flex. 3
Ext. 2+

Hip Flex. 4
Ext. 4
Abd. 5
Add. 5

Knee Flex. 4−
Ext. 4

Ankle Dorsi flex. 4
Plantar flex. 5
Table 2.
Medical Research Council(MRC) Scale
Grade
0 No contraction
1 Flicker or trace contraction
2 Active movement, with gravity eliminated
3 Active movement against gravity
4 Active movement against gravity and resistance
5 Normal power
Table 3.
The Change of Motor Grade of Rt. Side
8. 9 9. 6 9. 11 10. 10 11. 5
Shoulder Flex. 3 3+ 4− 4 5
Ext. 3+ 4 4 4 5
Abd. 3 4 4 4 5
Add 3+ 4 4 4 5

Elbow Flex. 3+ 4 4 4+ 5
Ext. 2− 3− 3 3+ 4

Wrist Flex. 2− 3 3 3 4+
Ext. 3+ 4− 4 4+ 5

Finger Flex. 3 3+ 4 4 4+
Ext. 2+ 3 3 3 4

Hip Flex. 4 4 4+ 5 5
Ext. 4 4 4+ 5 5
Abd. 5 5 5 5 5
Add. 5 5 5 5 5

Knee Flex. 4− 4 4 4 4+
Ext. 4 4 4 4 4+

Ankle Dorsi Flex. 4 4 4 4 4
Plantar Flex. 5 5 5 5 5
Table 4.
The Change of Sensory Function of Lt. Side
Loss of sensory function
Pain sense Temperature sense
Admission Below T1 Below C8
15 days Below T4 Below T3
1 months Below T6 Below T4
2 months Below T6 Below T4
3 months (discharge) Below T6 Below T4
Table 5.
The Change of MBI
MBI(max=100)
Admission 77
1 months 86
2 months 93
3 months(discharge) 97
V.
V.

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