A Case Report of Brown-Sequard Syndrome Caused by Traumatic Cervical Fracture

Article information

Acupunct. 2015;32(1):133-140
1Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Wonkwang University
2Department of Physiology, College of Korean Medicine, Wonkwang University
3Department of Rehabilitation, Wonkwang University Iksan Korean Medicine Hospital
*Corresponding author: Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Wonkwang University, 895, Muwang-ro, Iksan-si, Jeollabuk-do, 570-711, Republic of Korea, Tel: +82-63-859-2812, E-mail: choandle@hanmail.net
Received 2015 January 23; Revised 2015 March 02; Accepted 2015 March 05.

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

Fig. 2.

Pre OP state of C-spine MRI axial view

Fig. 3.

Post OP state of C-spine X-ray

Motor Grade of Rt. Upper/ Lower Extremity at Admission

Medical Research Council(MRC) Scale

The Change of Motor Grade of Rt. Side

The Change of Sensory Function of Lt. Side

The Change of MBI

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Article information Continued

Fig. 1.

Pre OP state of C-spine MRI saggital view

Fig. 2.

Pre OP state of C-spine MRI axial view

Fig. 3.

Post OP state of C-spine X-ray

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