A 62yo woman complains of unsteadiness when walking. On examination she has pyramidal
weakness of her left lower limb and reduced pain and temp sensation on right leg and right side
of trunk up to the umbilicus. Joint position sense is impaired at her left great toe but is normal
elsewhere. She has a definite left extensor plantar response and the right plantar response is
equivocal. Where is the lesion?
a. Left cervical cord
b. Midline mid-thoracic cord
c. Right mid-thoracic cord
d. Left mid-thoracic cord
e. Left lumbo-sacral plexus
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ANSWER: D paralysis on same side = left lesion, level upto umbilicus
Brown-Séquard syndrome is caused by damage to one half of the spinal cord, resulting in paralysis and loss of proprioception
on the same (or ipsilateral) side as the injury or lesion, and loss of
pain and temperature sensation on the opposite (or contralateral) side
as the lesion.
dermatome levels:
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