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Repeated USMLE Questions Step 1- 310

A 28-year-old man presents to the emergency room after a bar fight in which he was shot. He is mildly distressed but oriented to place and time. Neurological examination reveals weakness of the right extremities with loss of touch, position and vibratory sensations on the same side accompanied by loss of pain and temperature on the left side.

What is the most likely diagnosis?

A-Anterior cord syndrome

B-Brown-Sequard syndrome

C-Central cord syndrome

D-Conus medullaris syndrome

E-Transverse myopathy

Answer



This is a typical case of unilateral spinal cord lesion known as Brown-Sequard syndrome. It is caused by trauma or tumor affecting one half of the spinal cord. It causes ipsilateral paresis or paralysis, ipsilateral loss of touch, position and vibratory sensations and contralateral loss of pain and temperature sensations.

The correct answer is B


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