Certified Rehabilitation Registered Nurse (CRRN) Practice Exam

What symptom is characteristic of Brown-Sequard syndrome?

1. Weakness greater in the upper extremities than in the lower

2. Loss of proprioception with preservation of other sensory and motor functions

3. Paralysis and loss of pain and temperature sensation with preservation of proprioception

4. Paralysis and loss of proprioception on the same side as the lesion with the loss of pain and temperature on the other side

The correct answer is: Paralysis and loss of proprioception on the same side as the lesion with the loss of pain and temperature on the other side

The characteristic symptom of Brown-Sequard syndrome is the distinct neurological pattern resulting from a hemisection of the spinal cord. This syndrome manifests as paralysis and loss of proprioception on the same side as the lesion while simultaneously presenting with loss of pain and temperature sensation on the opposite side. This phenomenon occurs due to the different pathways that sensory and motor information travel within the spinal cord. The corticospinal tract, responsible for motor control, and the dorsal columns, which carry proprioceptive and vibratory sense information, decussate at various levels in the central nervous system. Meanwhile, the spinothalamic tract, which transmits pain and temperature sensation, crosses over at the level of the spinal cord itself. As a result, when there is a hemisection, the deficits are highly localized based on which structures are affected, leading to the asymmetric presentation typical of Brown-Sequard syndrome. In summary, the hallmark of this syndrome is the preservation of certain functions while others are lost, emphasizing the complexity of the nervous system's organization and the specific deficits arising from unilateral spinal cord injury.