NURS 6501: Week 7 Quiz:
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Question 1
A 45-year-old male presents with asymmetrical sensory loss and motor weakness following a traumatic spinal cord injury. Upon examination, he demonstrates ipsilateral loss of motor function and proprioception, along with contralateral loss of pain and temperature sensation below the level of the lesion. Which of the following best explains these clinical findings?
Group of answer choices
- Posterior cord syndrome affecting dorsal columns and leading to loss of proprioception and fine touch
- Anterior cord syndrome resulting in loss of motor function and pain/temperature sensation
- Central cord syndrome causing bilateral motor and sensory loss
- Brown-Séquard syndrome leading to ipsilateral loss of motor function and proprioception, and contralateral loss of pain and temperature sensation
Correct answer:
Brown-Séquard syndrome leading to ipsilateral loss of motor function and proprioception, and contralateral loss of pain and temperature sensation
Explanation:
The patient’s presentation is classic for Brown-Séquard syndrome, which results from hemisection (partial injury) of the spinal cord. It leads to asymmetrical neurologic deficits based on the anatomy of the spinal tracts.
Key features of Brown-Séquard syndrome:
- Ipsilateral (same side as lesion):
- Loss of motor function (due to corticospinal tract damage)
- Loss of proprioception, vibration, and fine touch (due to dorsal column involvement)
- Contralateral (opposite side of lesion):
- Loss of pain and temperature sensation (due to spinothalamic tract crossing within a few levels of entry)
Why the other options are incorrect:
- Posterior cord syndrome: Affects proprioception and fine touch only (dorsal columns), but motor function is preserved
- Anterior cord syndrome: Causes bilateral loss of motor and pain/temp, sparing dorsal column modalities (proprioception/fine touch)
- Central cord syndrome: Often presents with greater motor loss in upper limbs than lower, and sparing of proprioception