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Brown-Séquard syndrome – causes, symptoms, diagnosis, treatment, pathology

What is Brown-Séquard syndrome? Brown-Séquard syndrome is a condition associated with hemisection or damage to one half of the spinal cord, resulting in a loss of sensations like pain, temperature, touch, as well as paralysis or loss of muscle function in some parts of the body.
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21 Responses

  1. L. Host

    Sorry but I think when you mean Lower Motor Neuron at minute 6:00 you should mean Upper Motor Neuron instead, because they come from higher segments in the Spinal Cord, therefore that’s an Upper motor neuron Lesion opposed to the fact of the Lower Motor Neuron Lesion that only happens at the segment level like you explained well short after, that will cause Flaccid Paralysis.

  2. Asma Ahad

    Thankyou so much for keeping me focused in the middle of night , you helped me so much by not spending hours to understand .

  3. Ali Tahir

    Just came through this vid. Good briefing. Here’s the answer to the most common doubt i noticed in comments regarding the symptomology of hemisectioning of corticospinal tract.
    Before we start, heres a basic concept u need to keep in mind.
    What does a motor neurone do?
    When triggered It ALWAYS contracts a muscle.
    To relax a muscle, the motor neurone needs to be inactive.
    Now Grab a paper and a pencil:

    Draw a brain and a spinal cord. Now graduate the spinal cord to thoracic vertebral columns, T1, T2, T3…….T12.
    Next, draw a corticospinal tract (just two to three vertical lines from the brain running down through the spinal cord). These are UMN. Draw a tiny synapses at T11 and draw another neurone from T11 extending laterally. These are LMN.
    Now, scribble two horizontal lines. The first at T5 and the second at T11. These horizontal lines depict sites of injuries.
    Now look at T5. What’s injured there?
    The UMN are injured. The LMN are fine and functioning. What do motor neurones do? They ALWAYS contract a muscle. These fine and functioning LMN are now stuck in an indefinite triggered phase. Sooo, they contract the muscles. That’s spastic paralysis. And this is referred to as UMN weakness.

    Now to T11. What’s injured?
    The LMN are injured. The UMN are fine but are incapable of transmitting signals to the skeletal muscles due to damage to LMN.
    What do motor neurones do?
    They ALWAYS contract.
    But the LMN are damaged. They can’t contract a muscle now. The muscle goes flaccid. That’s flaccid paralysis also referred to as LMN weakness.

    And heres a clinical picture to it on how to determine site of injury if the injury isn’t too evident.

    Let’s say you notice a discrepancy in midback, abdominal muscles and below.
    The midback and abdominal muscles are innervated by T5 segment of spinal column.
    Now use common sense. The corticospinal tract is a whole grouped bunch of fibres extending down in unison from the brain, through the spinal cord and THEN exiting the spinal cord to extend and innervate their destined muscles.
    For all neurones innervating muscle groups below T5, what group of neurone is injured?
    The UMN! So all these muscles suffer spastic paralysis.
    But at the level of T5, for those specific group of muscles innervated by T5, the LMN are injured, and so therefore, only that group of muscles suffer flaccid paralysis.
    You are welcome.

  4. Chevalier Ali

    Awesome video!
    But note that the central axons of the first order neurons in the spinothalamic tract give off ascending and descending branches BEFORE they enter the dorsal horn (via the tract of Lissauer) and THEN they synapse on the 2nd order neuron.

  5. Lorena Souza

    Thank you so much for this video! I've been trying to understand this syndrome and I couldn't do it so well, but now I'm good! God bless you all! ❤️🧠📖

  6. Maggie Biello

    Thank you. I have B.S.S. 5yrs. now and this video I just saw told me so much more than my doctor! Now what to do about it.

  7. رقية عبدالرحمن

    Really good & informative video but not all the pathway details are imp.
    As a student interested in neurology i loved those details but other students might have difficulty with it

    And as always thank you 🌸

  8. Caio Camisão

    As a brazilian medical student, I want to say thank you for this incredible video. Such a clean, smooth and organized video.

  9. indeevar prasad

    at 6.10 , its upper motor neuron lesion causing spasticity.and at the level of lesion it has flaccid paralysis bcoz of lower motor neuron lesion

  10. abubakar izge

    Hi, am physiotherapists from Nigeria, I really find your video interesting. Keep the good job.
    But I will suggest if you can expand your scope of video to the field of physical therapy.
    Pls I just wanna you to start doing videos in physical therapy. Thanks

  11. Ekaterina Shul

    Such a great video, guys! Thank you!
    There is one mistake I've noticed : 3:32 fibres of Spino-thalamic tract after they cross to controlateral side, in fact, they continue in a FRONT-LATERAL bandle of white matter in spinal cord (not at the back as it can appear from the video)
    That's important to mention
    All the rest is better than any tutorial I've seen
    Keep on doing medical studies more fun!

  12. Samuel Anantharaj

    A correction required !
    Thank you for the video.
    In 3:20, you've described first order neutrons for pain & temperature relaying in dorsal horn. Should it not be on the Lateral horn ?

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