ICD-10: S14.142

Brown-Séquard syndrome, particularly at the C2 level of the cervical spinal cord, is a specific neurological condition characterized by a hemisection of the spinal cord, leading to a distinct pattern of motor and sensory deficits. Here are some alternative names and related terms associated with ICD-10 code S14.142:

Alternative Names

1. Brown-Séquard Syndrome: This is the primary name for the condition, named after the French physiologist Charles Édouard Brown-Séquard, who first described it.
2. Hemisection Syndrome: This term refers to the condition's nature, where one side of the spinal cord is damaged, leading to unilateral symptoms.
3. Cervical Brown-Séquard Syndrome: This specifies the location of the syndrome at the cervical level, particularly at C2.
4. C2 Brown-Séquard Syndrome: A more specific term indicating the exact vertebral level affected.

Related Terms

1. Spinal Cord Injury (SCI): A broader term that encompasses any injury to the spinal cord, which can lead to various syndromes, including Brown-Séquard syndrome.
2. Neurological Deficits: This term refers to the loss of normal function in the nervous system, which is a key feature of Brown-Séquard syndrome.
3. Unilateral Weakness: A common symptom of Brown-Séquard syndrome, where weakness occurs on one side of the body.
4. Sensory Loss: Refers to the loss of sensation, which can be specific to certain modalities (e.g., pain, temperature, proprioception) depending on the side of the injury.
5. Cervical Spinal Cord Syndromes: A category that includes various syndromes resulting from injuries at the cervical level, including Brown-Séquard syndrome.

Clinical Context

Brown-Séquard syndrome is often the result of trauma, tumors, or other pathological processes affecting the spinal cord. The symptoms typically include:
- Ipsilateral motor paralysis: Weakness or paralysis on the same side as the injury.
- Contralateral sensory loss: Loss of pain and temperature sensation on the opposite side of the body.

Understanding these alternative names and related terms can aid in better communication among healthcare professionals and enhance the clarity of medical documentation and coding practices.

Brown-Séquard syndrome is a neurological condition resulting from hemisection of the spinal cord, leading to a characteristic pattern of motor and sensory deficits. The ICD-10 code S14.142 specifically refers to Brown-Séquard syndrome at the C2 level of the cervical spinal cord. Here’s a detailed overview of the criteria used for diagnosing this condition.

Clinical Presentation

Symptoms

The diagnosis of Brown-Séquard syndrome typically involves the following clinical features:

1. Motor Deficits:
   - Weakness or paralysis on the same side (ipsilateral) as the injury due to damage to the corticospinal tract, which carries motor signals from the brain to the body.
   - The degree of weakness can vary depending on the extent of the injury.

2. Sensory Deficits:
   - Loss of proprioception and vibratory sense on the same side (ipsilateral) as the injury, due to damage to the dorsal columns of the spinal cord.
   - Loss of pain and temperature sensation on the opposite side (contralateral) of the body, resulting from damage to the spinothalamic tract, which carries pain and temperature sensations.

Reflex Changes

• Deep Tendon Reflexes: These may be exaggerated on the side of the injury due to upper motor neuron involvement.
• Babinski Sign: A positive Babinski sign may be present on the affected side.

Diagnostic Criteria

Neurological Examination

A thorough neurological examination is essential for diagnosis. Key components include:

• Assessment of Motor Function: Evaluating strength and tone in the upper and lower limbs.
• Sensory Testing: Testing for proprioception, vibration, pain, and temperature sensation on both sides of the body.
• Reflex Testing: Checking deep tendon reflexes and pathological reflexes.

Imaging Studies

• MRI or CT Scans: Imaging studies are crucial for visualizing the spinal cord and identifying any structural abnormalities, such as tumors, herniated discs, or trauma that may have caused the hemisection.

History and Risk Factors

• Patient History: A detailed history of the onset of symptoms, any traumatic events, or underlying conditions (e.g., tumors, infections) that could lead to spinal cord injury is important.
• Risk Factors: Consideration of risk factors such as previous spinal injuries, degenerative diseases, or congenital conditions.

Differential Diagnosis

It is also important to rule out other conditions that may present similarly, such as:

• Complete spinal cord injury
• Multiple sclerosis
• Transverse myelitis
• Other syndromes affecting the spinal cord

Conclusion

The diagnosis of Brown-Séquard syndrome at the C2 level involves a combination of clinical evaluation, imaging studies, and a thorough patient history. The characteristic pattern of motor and sensory deficits, along with supportive imaging findings, helps confirm the diagnosis and guide appropriate management strategies. Understanding these criteria is essential for healthcare professionals involved in the assessment and treatment of patients with spinal cord injuries.

Brown-Séquard syndrome is a neurological condition resulting from hemisection of the spinal cord, leading to a characteristic pattern of motor and sensory deficits. When this syndrome occurs at the C2 level of the cervical spinal cord, it presents with specific clinical features that are crucial for diagnosis and management. Below is a detailed overview of the clinical presentation, signs, symptoms, and patient characteristics associated with Brown-Séquard syndrome at the C2 level, corresponding to ICD-10 code S14.142.

Clinical Presentation

Overview of Brown-Séquard Syndrome

Brown-Séquard syndrome is characterized by a unilateral loss of motor function and sensory modalities below the level of the injury. This occurs due to the disruption of the corticospinal tract (motor pathways) and the spinothalamic tract (pain and temperature sensation) on opposite sides of the body. At the C2 level, the effects can be particularly pronounced due to the involvement of upper cervical nerves.

Signs and Symptoms

1. Motor Deficits:
   - Contralateral Hemiparesis: Weakness or paralysis on the side of the body opposite to the injury (e.g., right side weakness if the left C2 segment is affected) due to damage to the corticospinal tract.
   - Ipsilateral Upper Motor Neuron Signs: Spasticity, hyperreflexia, and the presence of a Babinski sign on the same side as the injury.

2. Sensory Deficits:
   - Contralateral Loss of Pain and Temperature Sensation: Loss of these sensations occurs on the side opposite to the injury due to the interruption of the spinothalamic tract.
   - Ipsilateral Loss of Proprioception and Vibration Sense: These sensations are lost on the same side as the injury due to damage to the dorsal columns (gracile and cuneate fasciculi).

3. Autonomic Dysfunction:
   - Patients may experience dysregulation of autonomic functions, including changes in blood pressure and heart rate, particularly if the injury is high in the cervical region.

4. Respiratory Complications:
   - Given the C2 level involvement, there may be respiratory difficulties due to the potential impact on the phrenic nerve, which innervates the diaphragm.

Patient Characteristics

• Demographics: Brown-Séquard syndrome can occur in individuals of any age but is more commonly seen in younger adults due to trauma (e.g., motor vehicle accidents, sports injuries).
• History of Trauma: Most cases are associated with traumatic events, but non-traumatic causes such as tumors, infections, or vascular issues can also lead to this syndrome.
• Neurological Examination: A thorough neurological examination is essential to assess the extent of motor and sensory deficits, as well as to evaluate for any additional complications.

Conclusion

Brown-Séquard syndrome at the C2 level presents a unique set of challenges due to its impact on both motor and sensory pathways. The clinical presentation typically includes contralateral motor weakness and sensory loss, along with ipsilateral proprioceptive deficits. Understanding these signs and symptoms is crucial for timely diagnosis and management, which may involve rehabilitation and supportive care to address the multifaceted needs of affected patients. Early intervention can significantly improve outcomes and quality of life for individuals with this condition.

Brown-Séquard syndrome, particularly at the C2 level of the cervical spinal cord (ICD-10 code S14.142), is a neurological condition resulting from hemisection of the spinal cord. This syndrome is characterized by a unique pattern of motor and sensory deficits due to the disruption of both ascending and descending pathways. Understanding the standard treatment approaches for this condition is crucial for effective management and rehabilitation.

Overview of Brown-Séquard Syndrome

Brown-Séquard syndrome typically arises from trauma, such as a spinal cord injury, tumors, or ischemia. The hallmark of this syndrome is the dissociation of sensory and motor functions: patients often experience ipsilateral motor paralysis and loss of proprioception, while contralateral loss of pain and temperature sensation occurs due to the crossing of sensory fibers in the spinal cord.

Standard Treatment Approaches

1. Immediate Medical Management

• Stabilization: The first step in managing a patient with suspected Brown-Séquard syndrome is to stabilize the spine to prevent further injury. This may involve immobilization and careful handling of the patient.
• Emergency Care: In cases of acute injury, emergency medical services should be contacted immediately. Patients may require airway management, breathing support, and circulation stabilization.

2. Surgical Intervention

• Decompression Surgery: If the syndrome is caused by a compressive lesion (e.g., a herniated disc or tumor), surgical intervention may be necessary to relieve pressure on the spinal cord.
• Stabilization Procedures: In cases of vertebral fractures or instability, surgical stabilization may be performed to prevent further damage to the spinal cord.

3. Rehabilitation Therapy

• Physical Therapy: A tailored physical therapy program is essential for improving mobility and strength. Therapists may focus on exercises that enhance muscle strength, coordination, and balance.
• Occupational Therapy: This therapy helps patients regain independence in daily activities. Occupational therapists may provide adaptive strategies and tools to assist with self-care tasks.
• Speech Therapy: If the injury affects swallowing or speech, a speech-language pathologist may be involved in the rehabilitation process.

4. Pharmacological Management

• Pain Management: Patients may experience significant pain due to nerve damage. Medications such as non-steroidal anti-inflammatory drugs (NSAIDs), opioids, or neuropathic pain agents (e.g., gabapentin) may be prescribed.
• Muscle Relaxants: To manage spasticity, muscle relaxants like baclofen may be utilized.
• Corticosteroids: In some cases, corticosteroids may be administered shortly after injury to reduce inflammation and improve outcomes, although their use is debated and should be considered on a case-by-case basis.

5. Long-term Management and Support

• Psychological Support: Patients may experience emotional and psychological challenges following a spinal cord injury. Counseling and support groups can be beneficial.
• Regular Follow-ups: Continuous monitoring and follow-up care are essential to address any complications and adjust treatment plans as necessary.

Conclusion

The management of Brown-Séquard syndrome at the C2 level involves a multidisciplinary approach that includes immediate medical care, potential surgical intervention, and extensive rehabilitation. Each treatment plan should be individualized based on the patient's specific needs and the extent of their injuries. Early intervention and comprehensive rehabilitation can significantly improve outcomes and enhance the quality of life for individuals affected by this condition.

Brown-Séquard syndrome is a neurological condition resulting from hemisection of the spinal cord, leading to a characteristic pattern of motor and sensory deficits. The specific ICD-10 code S14.142 refers to Brown-Séquard syndrome localized at the C2 level of the cervical spinal cord. Below is a detailed clinical description and relevant information regarding this condition.

Clinical Description of Brown-Séquard Syndrome

Pathophysiology

Brown-Séquard syndrome occurs when there is damage to one side of the spinal cord, which can result from trauma, tumors, or ischemia. The C2 level, located in the cervical region, is particularly significant as it is close to the brainstem and controls many vital functions. Damage at this level can lead to severe neurological deficits.

Symptoms

The hallmark of Brown-Séquard syndrome is the dissociation of sensory and motor functions:
- Motor Deficits: Patients typically experience weakness or paralysis on the same side as the injury (ipsilateral). This is due to the disruption of the corticospinal tract, which carries motor signals from the brain to the body.
- Sensory Deficits: On the opposite side (contralateral) of the body, patients may experience loss of pain and temperature sensation. This occurs because the spinothalamic tract, which transmits pain and temperature sensations, crosses over to the opposite side of the spinal cord before ascending to the brain.

Additional Symptoms

• Autonomic Dysfunctions: Depending on the extent of the injury, patients may also experience autonomic dysfunctions, such as changes in blood pressure, heart rate, and bladder control.
• Spasticity: Increased muscle tone and spasticity may develop on the affected side due to upper motor neuron lesions.

Diagnosis

Diagnosis of Brown-Séquard syndrome at the C2 level typically involves:
- Clinical Evaluation: A thorough neurological examination to assess motor and sensory functions.
- Imaging Studies: MRI or CT scans are often used to visualize the extent of spinal cord injury and to identify any underlying causes, such as tumors or herniated discs.

Treatment

Management of Brown-Séquard syndrome focuses on:
- Acute Care: Immediate treatment may involve stabilization of the spine and management of any acute injuries.
- Rehabilitation: Physical therapy and occupational therapy are crucial for maximizing recovery and improving functional outcomes.
- Medications: Pain management and muscle relaxants may be prescribed to alleviate symptoms.

Prognosis

The prognosis for individuals with Brown-Séquard syndrome can vary widely based on the extent of the injury and the timeliness of treatment. Some patients may experience significant recovery, while others may have lasting deficits.

Conclusion

ICD-10 code S14.142 specifically identifies Brown-Séquard syndrome at the C2 level of the cervical spinal cord, highlighting the unique clinical features associated with this condition. Understanding the symptoms, diagnostic approaches, and treatment options is essential for effective management and rehabilitation of affected individuals. Early intervention and comprehensive care can significantly improve outcomes for patients suffering from this syndrome.