Which spinal cord syndrome features ipsilateral motor paralysis and contralateral loss of pain and temperature?

Which spinal cord syndrome features ipsilateral motor paralysis and contralateral loss of pain and temperature?

• A. Anterior Cord Syndrome
• B. Posterior Column Syndrome
• C. Central Cord Syndrome
• D. Brown-Sequard Syndrome

Answer: (D)

A unilateral (hemicord) spinal cord injury produces a dissociated pattern: motor pathways on the same side as the lesion are disrupted, causing ipsilateral motor paralysis, while the spinothalamic tract that carries pain and temperature crosses to the opposite side within a few segments of entry, leading to contralateral loss of pain and temperature below the level of the lesion. This combination is characteristic of Brown-Sequard syndrome. In Brown-Sequard, you’d also expect ipsilateral loss of vibration and proprioception from dorsal column involvement below the lesion, but the key teaching point here is the opposite-sided pain/temperature loss with same-sided motor weakness. Other syndromes don’t produce this exact mix: anterior cord syndrome causes bilateral motor and pain/temperature loss with preserved dorsal-column function; posterior column syndrome causes loss of fine touch and proprioception with intact motor and pain/temperature; central cord syndrome typically presents with greater weakness in the upper limbs and different sensory patterns.

A unilateral (hemicord) spinal cord injury produces a dissociated pattern: motor pathways on the same side as the lesion are disrupted, causing ipsilateral motor paralysis, while the spinothalamic tract that carries pain and temperature crosses to the opposite side within a few segments of entry, leading to contralateral loss of pain and temperature below the level of the lesion. This combination is characteristic of Brown-Sequard syndrome.

In Brown-Sequard, you’d also expect ipsilateral loss of vibration and proprioception from dorsal column involvement below the lesion, but the key teaching point here is the opposite-sided pain/temperature loss with same-sided motor weakness. Other syndromes don’t produce this exact mix: anterior cord syndrome causes bilateral motor and pain/temperature loss with preserved dorsal-column function; posterior column syndrome causes loss of fine touch and proprioception with intact motor and pain/temperature; central cord syndrome typically presents with greater weakness in the upper limbs and different sensory patterns.