You are on the scene of a domestic assault in which the female victim defended herself against further attack by stabbing her attacker. Your patient is a 36-year-old man who has been stabbed in the posterior thorax about 1 centimeter to the right of the spinous process of T6. Your assessment reveals loss of motor and sensory function on the right side distal to T6 but intact motor function with some loss of sensation on the left side distal to T6. Which of the following best explains this patient's presentation?
A) "Pseudoneurologic" deficit to avoid being arrested
B) Brown-Séquard syndrome
C) Central cord syndrome
D) Autonomic hyperreflexia

Question

Quizplus · Accepted Answer

The loss of motor and sensory function on the right side distal to T6 and intact motor function with some loss of sensation on the left side distal to T6 is indicative of Brown-Séquard syndrome, which is caused by damage to one half of the spinal cord. This fits with the patient's injury being on the posterior thorax on one side of the spine. It is not likely that the patient has a "pseudoneurologic" deficit, as the injury is in a specific location, and autonomic hyperreflexia typically presents with symptoms such as high blood pressure and sweating. Central cord syndrome involves damage to the center of the spinal cord, and the symptoms would not be isolated to one side of the body.

You Are on the Scene of a Domestic Assault in Which