Mystery Case: Brown-Séquard syndrome caused by idiopathic spinal cord herniation

Erich Talamoni Fonoff, William Omar Contreras Lopez, Manoel Jacobsen Teixeira

Research output: Contribution to journalReview articlepeer-review

4 Scopus citations

Abstract

A 48-year-old man developed numbness in the left leg, which progressed gradually to paresis and urinary incontinence. Neurologic examination revealed a left Brown-Sequard syndrome with leg paresis, mild spasticity, reduced proprioception, and contralateral thermal and painful hypoesthesia below T6. MRI revealed a thoracic spinal cord herniation (SCH) (figure). Idiopathic SCH is relatively rare. Pathogenesis involves a dura mater defect (see video on the Neurology® Web site at Neurology.org); herniation develops over a progressive pressure gradient through the dural fissure. 2 Surgical reduction is typically performed if symptoms progress, but mild symptoms may be eligible for conservative treatment and monitoring. Surgical spinal reduction and dural repair usually reverses neurologic deficits.

Original languageEnglish
Pages (from-to)e34
JournalNeurology
Volume87
Issue number4
DOIs
StatePublished - 26 Jul 2016
Externally publishedYes

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