Paramedic National Registry Practice

A patient stabbed in the back presents with right-sided paralysis. Which syndrome is this indicative of?

1. Complete spinal injury

2. Brown-Sequard's syndrome

3. Anterior cord syndrome

4. Cauda equina syndrome

The correct answer is: Brown-Sequard's syndrome

Brown-Sequard's syndrome is characterized by a hemisection of the spinal cord, which results in a unique presentation of neurological deficits. In this case, the patient who has been stabbed in the back and presents with right-sided paralysis suggests damage to the right side of the spinal cord. In Brown-Sequard's syndrome, the individual typically experiences motor paralysis on the same side as the injury due to disruption of the corticospinal tract, which carries motor signals from the brain to the body. Additionally, the patient may also have loss of sensory function, such as pain and temperature sensation on the opposite side of the body due to the involvement of the spinothalamic tract, which crosses to the opposite side before ascending. This distinct pattern of deficits directly correlates with the unilateral injury, making it a classic example of Brown-Sequard's syndrome. Other types of spinal cord injuries listed, such as complete spinal injury, anterior cord syndrome, and cauda equina syndrome, present with different and broader patterns of motor and sensory deficits, which do not fit the scenario of isolated right-sided paralysis without corresponding sensory changes. Therefore, the indication of right-sided paralysis due to a stab wound suggests a hemisection type of injury, which is