Wan say na yu bɔdi de swɛ ɛn di ɔda say nɔ de swɛ? Yu tink se na Brawn-Sɛkwad Sindrom?

Yu dɔn ɛva yɛri bɔt wan strenj kɔndishɔn we yu nɔ ebul fɔ muv wan say na yu bɔdi ɛn nɔ fil natin na di ɔda say? I kin apin afta aksidɛnt. I kin mek yu fred smɔl, bɔt tide wi go tɔk bɔt wan sik we kin apin di rayt tɛm, bɔt i nɔ kin rili kɔmɔn, we dɛn kɔl Brown-Séquard Syndrome . Nɔ wɔri, lɛ wi tɔk bɔt am simpul wan.

Wetin na Brown-Séquard Syndrome, dis sik we dɛn kɔl strenj nem?

Fɔ tɔk am simpul wan, Brown-Séquard syndrome (BSS) na wan sik we nɔ kin apin so ɔltɛm na di nyurolɔjik. I kin apin we yu spɛnal kɔd dɔn pwɛl , bɔt di damej kin jɔs de na wan say na di spɛnal kɔd. Tink bɔt am lɛk yu spɛnal kɔd, we tan lɛk kebul we de kɛr mɛsej dɛn frɔm yu bren ɔlsay na yu bɔdi ɛn afta dat i de kɛr infɔmeshɔn frɔm yu bɔdi bak to yu bren. So dis prɔblɛm kin jɔs apin we jɔs wan say na dis kebul dɔn pwɛl.

wetin kin apin na di sem say na di spεnal kכd we bin dכn pwεl, di mכsul dεm we de dכn wik כ paralayz de dכn di lεvεl we di damej de. Dis min se yu nɔ go ebul fɔ muf da say de. Bɔt, i sɔprayz fɔ no se di sɛns fɔ pen ɛn tɛmpracha de lɔs na di ɔda say , bɔt i de dɔŋ di lɛvɛl we di damej dɔn. I tan lɛk se i kɔmplikt smɔl, nɔto so? Lɛ wi ɛksplen mɔ.

yu spεnal kכd na wan silinda we de kכmכt frכm di bren stεm כl di we dכn to di bכs pat pan yu spayna. I rili dilik. I mek wit bɔku bɔku nɛv fayv dɛn. Na wan big pat pan wi nervɔs sistɛm.

Dɛn kin tek Brown-Séquard syndrome as inkɔmplit spɛshal kɔd injuri (SCI) . dis min se sכm lכs de lכs fכ fil, mכtalman fכnshכn, כ כl tu dכn di say we di injuri de. insay komplit SCI, nכ sensεshכn כ muvmεnt de dכn di injuri sayt.

Dɛn gi am in nem to wan sayɛnsman we nem Chals-Idɔd Brawn-Sɛkwad, we bin tɔk bɔt dis sik fɔ di fɔstɛm insay 1849.

Aw dis difrɛn frɔm Sɛntral Kɔd Sindrom?

Yu go dɔn yɛri bak bɔt Sɛntral Kɔd Sindrom (CCS) . Pan ɔl we dɛn ɔl tu na injury na di spaynal kɔd we nɔ kɔmplit, dɛn na tu difrɛn kɔndishɔn.

CCS na injuri we nɔ kɔmplit na di midul pan di spaynal kɔd, bɔku tɛm na di nɛk. Dis kin mek di an dɛn wik pas di leg dɛn.

Bɔt insay BSS , we ɛni pat pan di spɛnal kɔd we de na wan say pwɛl, dat kin mek di say we di sik afɛkt paralayz, we di ɔda say nɔ kin fil fayn igen. Yu ɔndastand di difrɛns?

Udat kin gɛt dis sik? Aw i kɔmɔn?

Brown-Séquard syndrome kin afɛkt ɛnibɔdi. Bɔt, na tin we nɔ kin apin so ɔltɛm.Dis kin apin ilɛksɛf na man ɔ uman.

Insay Amɛrika nɔmɔ, dɛn kin ripɔt lɛk 12,000 nyu wan dɛn we kin gɛt injury na dɛn spaynal kɔd ɛvri ia. Fɔ dɛn wan ya, na 2% to 4% nɔmɔ BSS gɛt. Dis min se na Sri Lanka, di rit kin ivin smɔl.

Wetin na di sayn dɛm wae de sho se yu gɛt Brown-Séquard syndrome (BSS)?

di simptom dεm fכ BSS kin bigin afta we wan say na di spεnal kכd dεm dכn pwεl.

Di fɔs sayn dɛm wae de sho se yu gɛt dis sik na:

• we yu nכ ebul fכ muv di limb dכn di injuri (dεn de lכs di mכsul muvmεnt) na di sem say na di spεnal kכd injuri. Dis kin bigin as wikɛd ɛn go bifo te i paralayz.
• na di כda say, di pen de lכs εn tεmprachכ sεns dεm dכn di lεvεl fכ di injuri.

Tink bɔt am dis we. if pכsin gεt BSS, we na spεnal kכd injuri na di rayt say na in spayna, i nכ go ebul fכ muv in rayt sayd, dat na frכm di midul pan in spayna dכn – in rayt hip, leg, εn fut. כltu, na di lεft say, frכm di midul pan dεn spayna dכn, dεn go lכs pen εn fil כt/kol, bכt dεn go ebul fכ muv dεn lεft sayd. Di ed, nɛk, sholda, ɛn an dɛn go wok nɔmal wan, ɛn dis injuri nɔ go afɛkt am.

Apat frɔm dat, BSS kin mek yu gɛt sɔm sayn dɛn lɛk:

• I nɔ ebul fɔ kɔntrol di urine ɛn stɔl (urinary ɛn fecal incontinence).
• di mכsul dεm wik εn west (mכsul atrofi) na di εria we di sik afekt.

Di sayn dɛm fɔ BSS kin rili smɔl fɔ sɔm pipul dɛm, ɛn kin rili bad fɔ ɔda pipul dɛm. Bɔt if dɛn trit dɛn fayn, dɛn sik ya kin bɛtɛ smɔl smɔl .

Yu tink se dis kin mek pɔsin fil bad?

If di tin we mek BSS na bad bad tin lɛk we pɔsin shot am ɔ we i gɛt motoka aksidɛnt, dat min se di aksidɛnt go mɔs mek pɔsin fil pen. Bɔt bikɔs ɔf di sindrom insɛf, dat na di damej we di spɛnal kɔd dɔn pwɛl, i nɔ kin gɛt pen.

Bɔt sɔm pipul dɛn we gɛt BSS kin gɛt abnɔmal sɛns (dysesthesia) bikɔs ɔf di spɛnal kɔd we dɔn pwɛl, we kin bi we dɛn kin bɔn, prɛkl, ɔ tingling.

Wetin na di men tin wae kin mek pɔrsin gɛt Brown-Séquard syndrome (BSS)?

di tin dεm we kin kכmכn fכ BSS na di injuri dεm na di spεnal kכd:

• Gɔn shot dɛn.
• Fɔ chuk pɔsin wit sɔd.
• Aksidɛnt dɛn we kin apin na motoka.
• Blunt trauma we nɔ gɛt wan prɔblɛm.
• Spinal fraktrɔs frɔm aksidɛnt lɛk we pɔsin fɔdɔm.

If yu gɛt aksidɛnt lɛk dis, i rili impɔtant fɔ go na di ɔspitul we de nia yu kwik kwik wan ɛn go to dɔktɔ wantɛm wantɛm.

Apat frɔm dis, BSS kin apin bak bikɔs ɔf tin dɛn we nɔto aksidɛnt, bɔt dɛn nɔ kin bɔku smɔl:

• Spɔndilɔsis na di sɛvikal.
• Dikɔmpreshɔn sik na wan sik we kin apin afta dɛn dɔn put am pan prɛshɔn we pasmak ɔnda wata.
• Slip disk na di spayna (hεnia disk).
• Infεkshכn dεm lεk mεningayt.
• Mɔltipɛl Sklɛrosis (MS).
• Di we aw pɔsin kin gɛt raytin.
• di bכdi we de blכk di bכdi we de gi di spεnal kכd (spinal ischemia).
• Spinal tכmכro dεm.
• Transvas maylaytis we gɛt di sik.
• Tubakulosis sik we dɛn kɔl Tuberculosis.

Aw dɔktɔ dɛn kin no bɔt dis? (Diagnosis) .

If yu dɔktɔ sɔprayz se yu gɛt BSS, i go du dɛn tin ya:

• I de du wan kɔmplit ɛgzam pan in bɔdi .
• Dɛn kin du nyurolɔjik ɛgzam we de chɛk di muvmɛnt ɛn sɛns ditayli.
• Dɛn go aks bɔt yu mɛdikal istri, yu nyurolɔjik prɔblɛm, ɛn ɛni aksidɛnt we yu dɔn gɛt.

Dɔn, dɛn go ɔda fɔ mek dɛn du bɔku tɛst dɛn, lɛk fɔ du MRI skan , fɔ no if pɔsin gɛt di sik ɛn fɔ chɛk fɔ ɔda tin dɛn we mek i gɛt di sik.

Us tɛst dɛn de du fɔ dis?

If yu tink se yu gɛt BSS, yu dɔktɔ kin ɔda fɔ du tɛst lɛk:

• MRI skan (Magnetic Resonance Imaging): Dis na tɛst we nɔ de mek pɔsin fil pen. I de yuz big magnet, redio wev, ɛn kɔmpyuta fɔ mek pikchɔ dɛn we rili klia bɔt di ɔgan dɛn ɛn di tin dɛn we de insay di bɔdi. MRI rili yusful fɔ BSS bikɔs i kin ɛp fɔ no di strɔkchɔral damej na di spayna ɛn ɛp fɔ fɛn di kɔz fɔ BSS we kin apin we nɔ gɛt aksidɛnt.
• Maylogram ɛn CT skan (Computed Tomography): If yu nɔ ebul fɔ du MRI, yu dɔktɔ kin ɔda fɔ mek dɛn du maylogram ɛn afta dat dɛn fɔ du CT skan na yu spayna. dis tεst dεm kin luk fכ di damej pan di nεv tisu na wan say na yu spεnal kכd. Maylogram na imej tɛst we de chɛk di kɔnekshɔn bitwin yu spayna, disk, spɛshal kɔd, nɛv, ɛn nerv rut. CT skan kin yuz X-ray ɛn kɔmpyuta fɔ mek ditayli pikchɔ dɛn bɔt di insay pat na yu bɔdi.
• Blɔd tɛst: If nɔ klia wetin mek yu gɛt BSS, yu dɔktɔ kin tɛl yu fɔ du bɔku blɔd tɛst fɔ chɛk fɔ si if pɔsin gɛt infɛkshɔn we go mek yu gɛt di sik.
• Lumbar pancture / Spinal tap: If dɛn tink se na multiple sclerosis (MS) , transverse myelitis, ɔ tuberculosis de mek yu gɛt BSS, yu dɔktɔ kin du lumbar pancture fɔ tek wan sɛmpul fɔ cerebrospinal fluid (CSF) . CSF na di klia wata we de rawnd yu spεnal kכd εn bren.

Wetin na di tritmɛnt fɔ Brown-Séquard syndrome (BSS)?

di tritmεnt fכ BSS dipכnt pan di כndalayn kכz fכ di spεnal kכd dεm we de pwεl .

In jɛnɛral, di gol dɛm fɔ BSS tritmɛnt na:

• fכ kip כ impruv di mכtalman εn sεns fכnshכn.
• Fɔ mek dɛn nɔ gɛt sɛkɔndari damej.
• Fɔ mek di prɔblɛm dɛn we kin apin smɔl.

Pɔsin we gɛt BSS frɔm shap wɛpɔn injuri, lɛk naif stab wund, go nid fɔ trit fɔ blɔd ɛn tisu damej. Apat frɔm dat, pipul dɛn we gɛt ɔda injuri frɔm di aksidɛnt we mek BSS go nid ɔda tritmɛnt fɔ dɛn injuri dɛn de bak.

Tu men pat dɛn de fɔ trit BSS: fɔs tritmɛnt ɛn rihabiliteshɔn .

Di Fɔs Tritmɛnt

Di fɔs tritmɛnt fɔ BSS kin inklud:

• Ɔpreshɔn: Insay kes dɛm we BSS apin we nɔ gɛt aksidɛnt, i kin bi bikɔs ɔf mɛkanikal kɔmpreshɔn ɔ hεnia na di spaynal kɔd. Dɛn nid fɔ du ɔpreshɔn fɔ mek dɛn nɔ gɛt dis kɔmpreshɔn.
• Mεdikeshכn dεm we de mek blכd kכlכt: Pipul dεm we gεt spεnal kכd injuri kin gεt bכku risk fכ divεlכp blכd kכlכt na di vein dεm (Venous Thromboembolism - VTE) . Dis inklud tin dεm lεk dip vein thrombosis (DVT) εn pulmonary embolism . Yu dɔktɔ kin gi yu mɛrɛsin dɛn we dɛn kɔl antikoagulant , lɛk ɛparin ɔ wɔfarin, fɔ mek yu blɔd nɔ klɔt.
• Fɔ protɛkt di skin (fɔ mek yu nɔ gɛt bed swɛ): Fɔ mek yu nɔ gɛt prɛshɔn injuri/beds, yu mɛdikal tim go ɛp yu fɔ tɔn ɛn chenj yu pozishɔn at le ɛvri tu awa. Dɛn go ɛp fɔ mek yu skin klin ɛn dray, ɛn put mɔstizayza pan dray skin.
• Gastrostomy tube (G-tube): Fɔ ridyus di risk fɔ mek yu bɛlɛ blo bikɔs ɔf paralytic ileus, yu dɔktɔ kin put G-tube na yu bɛlɛ. G-tyub na tכb we de gi nyutrishכn dairekt frכm di bεlε to di bεlε. Paralytic ileus na we di mכsul dεm we de kכntrakt fכ sכm tεm we de muv it tru di intestines. Dis kin kכmכn pan spεnal kכd injuri.
• Sɔpɔt fɔ di we aw yu de blo: If i nɔ izi fɔ yu fɔ blo bikɔs yu gɛt injury na yu spɛnal kɔd, yu kin nid fɔ kɔnɛkt yu to ventilator . Dis na mashin we de ɛp yu fɔ blo, ɔ blo fɔ yu.
• Nyurojenik blad mεnejmεnt: Pipul dεm we gεt spεnal kכd injuri, inklud BSS, kin lכs blad kכntrכl. If dis apin, dɛn kin nid fɔ yuz urinary catheter ɛn ɔda tritmɛnt dɛn we gɛt fɔ du wit urinary system.
• Autonomic dysreflexia tritmεnt: Pipul dεm wae gεt spεnal kכd injury kin gεt bכku chenj dεm na dεn blɔd prεshכn εn כda simptom dεm. Dɛn fɔ tek tɛm trit dis wit mɛrɛsin dɛn we de kɔntrol blɔd prɛshɔn ɛn at rit.
• Blanket we de rigul di tɛmpracha: Bɔku tɛm, pipul dɛn we gɛt BSS kin gɛt prɔblɛm fɔ rigul dɛn bɔdi tɛmpracha. Di mɛdikal tim kin gi blankit dɛn we de mek di ples wam fɔ ɛp fɔ du dis.

Rihabiliteshɔn

Afta di fɔs tritmɛnt fɔ BSS, rihabiliteshɔn, lɛk fizik tɛrapi ɛn ɔkupeshɔn tɛrapi , fɔ bigin kwik kwik wan fɔ mek i bɛtɛ ɛn/ɔ fɔ mek i ebul fɔ muv bak.

Gol dɛm fɔ fyzikal tritmɛnt:

• Mek di mכsul dεm trεnk wit gud nεv fכnshכn.
• Mek di rεnj fכ muvmεnt na di jכyn dεm.
• Nɔ mek di skin brok tru di rayt we aw yu de tinap ɛn we yu de chenj di wet.
• Fɔ mek pɔsin ebul fɔ muv fayn fayn wan .

Fizik tritmɛnt involv ɛksɛsayz ɛn tritmɛnt dɛm wae de ɛp yu fɔ ridyus pen ɛn mek yu bak to nɔrmal woke ɛn muv. Yu fizik thɛrapist go wok wit yu fɔ mek yu ebul fɔ muv fayn fayn wan. Dɛn kin gi yu tin dɛn we go ɛp yu fɔ du ɛvride wok, lɛk bres, an splin, sɔpɔt fɔ yu an ɛn fut, ɔ wilchia.

Ɔkupeshɔn tɛrapi involv tritmɛnt ɛn ɛksesaiz dɛm wae de ɛp yu fɔ gɛt indipɛndɛns bak pan ɔltin na yu layf afta yu gɛt prɔblɛm wit yu bɔdi ɔr yu nyurolɔjik. We yu gɛt ɔkupeshɔn tɛrapi fɔ BSS, yu go lan nyu we fɔ du ɛvride wok, lɛk fɔ klin yusɛf, it, ɛn drɛs, wit ɔ nɔ gɛt ɛnitin fɔ ɛp yu.

Yu tink se dɛn go ebul fɔ mek dis nɔ apin?

Di wangren we fɔ mek yu nɔ gɛt Brown-Séquard syndrome na fɔ fala di standad sefty prɛkoshɔn fɔ mek yu nɔ pwɛl yu spɛnal kɔd. Fɔ ɛgzampul, tek tɛm we yu de drayv ɛn waka na rod.

Wetin na de chans fɔ wɛl frɔm dis sik? (Prɔgnosis) .

di luk fכ rεkכvεshכn frכm BSS dipכnt pan sεvεra tin dεm, inklud di kכz fכ di spεnal kכd dεm εn aw di damej de sכmtεm.

Bɔt, ɔltogɛda, di rεkכvεri rεt frכm BSS jεnarali gud . Pipul wae gɛt BSS gɛt gud chans fɔ gɛt sɔm pan dɛn wok bak, inklud fɔ waka. Bɔt fɔ wɛl na tin we nɔ kin apin sloslo . Di wɛl bɔdi kin slo smɔl, i kin tek tri to siks mɔnt frɔm di tɛm we di sik bigin, ɛn i kin tek tu ia fɔ mek di nerv dɛn wɛl ɔlsay.

Us prɔblɛm dɛn kin apin if dɛn nɔ trit am?

If dɛn nɔ trit Brown-Séquard syndrome, prɔblɛm dɛn lɛk:

• Di bɛlɛ we de kɔmɔt na di bɛlɛ.
• Pwɛl at.
• Lɔw blɔd prɛshɔn (Hypotension).
• Pɔlmonari ɛmbolizm.
• Infεkshכn – mכst na di lכng εn di urinary tract.
• Paralayz we go de sote go.

Wetin na di bɛst tɛm fɔ go to dɔktɔ?

If yu gɛt mɔsul dɛn wik ɔ paralayz wantɛm wantɛm ɛn/ɔ yu nɔ de fil fayn na wan say na yu bɔdi, go na di imejensi rum we de nia yu kwik kwik wan .

If dɛn dɔn no se yu gɛt Brown-Séquard syndrome, yu fɔ si yu mɛdikal tim ɔltɛm fɔ mek shɔ se yu spɛnal kɔd injuri de wɛl fayn fayn wan. Mek shɔ se yu kip yu fizik tɛrapi ɛn ɔkupeshɔn tɛrapi apɔntinmɛnt fɔ mek shɔ se yu wɛl ɛn kwik kwik wan.

Di tin we impɔtant pas ɔl fɔ mɛmba (Take-Home Message) .

Brown-Séquard syndrome kin mek yu fred smɔl fɔ yɛri. Bɔt di gud nyus na dat bɔrku pipul dɛm wae gɛt dis sik kin gɛt bak ɔr kin ɛp dɛn fɔ ebul fɔ du tin fayn fayn wan afta sɔm mɔnt wae dɛn dɔn wɛl. Mɛmba se yu mɛdikal tim go de ɔltɛm fɔ ɛp yu fɔ go bak na di rayt rod. So kɔntinyu fɔ strɔng ɛn fala di advays we dɛn gi yu.

` Brown-Séquard Syndrome, spεnal kכd, spεnal kכd, nεv dεm, paralayz, lכs fכ sεns, spεnal kכd dεm dεm