Which injury pattern produces ipsilateral motor and light touch loss with contralateral loss of pain and temperature?

• A. Anterior cord syndrome
• B. Central cord syndrome
• C. Spinal shock
• D. Brown-Sequard syndrome

Answer: (D)

This pattern comes from a hemisection of the spinal cord. When one side is damaged, the tracts on that side produce ipsilateral motor weakness because the corticospinal tract controls voluntary movement there. The same side’s dorsal columns carry fine touch, vibration, and proprioception, so those functions are lost ipsilaterally as well. The pain and temperature fibers (spinothalamic tract) cross to the opposite side near the level they enter, so those sensations are lost on the opposite, or contralateral, side below the lesion. Put together, ipsilateral motor and light touch loss with contralateral loss of pain and temperature is the hallmark of Brown-Sequard syndrome.

The other patterns don’t fit as neatly. Anterior cord syndrome mainly affects motor and pain/temperature on both sides with preserved fine touch and proprioception because the dorsal columns are spared. Central cord syndrome often presents with greater weakness in the upper extremities and a more diffuse sensory pattern rather than a clean ipsilateral/contralateral split. Spinal shock is a temporary phase right after injury with general flaccid weakness and loss of reflexes, not a stable lateralized deficit pattern.