How is Brown-Séquard syndrome treated?
How is Brown-Séquard syndrome treated?
The treatment for Brown-Séquard syndrome (BSS) depends on the underlying cause of the spinal cord damage.
In general, the treatment goals for Brown-Séquard syndrome include:
- Preserving or improving motor and sensory function.
- Preventing secondary injuries.
- Minimizing complications.
People who have BSS as the result of a penetrating injury will need to be treated for bleeding and direct tissue damage. Similarly, people with BSS who have other injuries from the trauma that caused BSS will need additional treatment for those injuries.
There are two general phases of treatment for BSS, including initial treatment and rehabilitation.
Initial treatment of Brown-Séquard syndrome
General therapies for initial treatment of BSS may include:
- Surgery: Non-traumatic causes of BSS usually involve mechanical compression or herniation of your spinal cord that requires surgical treatment to alleviate the compression.
- Medication to prevent blood clots: People with spinal cord injuries have the highest rate of venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism, among people with severe trauma. Your provider will likely give you medications known as anticoagulants, such as heparin or warfarin, to try to prevent blood clots.
- Skincare to prevent pressure injuries (bedsores): To try to prevent pressure injuries, your healthcare team will help you rotate and reposition your body at least every two hours. They’ll keep your skin clean and dry and treat dry skin with moisturizers.
- Gastrostomy tube (G-tube) placement: Your provider may place a G-tube in your belly to reduce the risk of abdominal distension caused by paralytic ileus. A gastrostomy tube (G-tube) is a tube inserted through your belly that brings nutrition directly to your stomach. Paralytic ileus occurs when the muscle contractions that move food through your intestines are temporarily paralyzed, which is common in spinal cord injuries.
- Breathing support: If your spinal cord injury is causing issues with breathing, you may need to be on a ventilator, which is a machine that helps you breathe or breathes for you.
- Neurogenic bladder management: People with spinal cord damage, including BSS, may lose control of their bladder. A urinary catheter and other urological treatments may be required if this happens.
- Autonomic dysreflexia treatment: People with spinal cord damage may have marked fluctuations in blood pressure and other symptoms that may need careful management with blood pressure and heart medications.
- Temperature-regulating blankets: People with BSS often can’t regulate their body temperatures. Your healthcare team may provide temperature-regulating blankets to help with this.
Rehabilitation for Brown-Séquard syndrome
After initial care for Brown-Séquard syndrome (BSS), rehabilitation in the form of physical and occupational therapy should begin as soon as possible to improve and/or regain motor function.
Physical therapy goals include:
- Maintaining strength in neurologically intact muscles.
- Maintaining range of motion in joints.
- Preventing skin breakdown by proper positioning and weight shifting.
- Improving mobility.
Physical therapy involves therapies and exercises to ease pain and help you function and move. Your physical therapist will work with you to improve your mobility. They may provide devices that help you continue daily activities, such as braces, hand splits, limb supports or a wheelchair.
Occupational therapy involves therapies and exercises that help people regain independence in all areas of their lives after a physical or neurological issue. During occupational therapy for BSS, you’ll learn new techniques, with or without the use of adaptive equipment, for everyday tasks, such as hygiene and grooming, eating and putting on clothes.