Indian Journal of Obstetrics and Gynecology Research 2021;8(4):572–576 Content available at: https://www.ipinnovative.com/open-access-journals Indian Journal of Obstetrics and Gynecology Research Journal homepage: www.ijogr.org Case Report Pregnancy following Brown-Séquard syndrome: A rare case report Shree Bharathi 1, *, Niveditha Jha 1 , Sasirekha Rengaraj 1 , Veena Ranjan 1 1 Dept. of Obstetrics and Gynecology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India ARTICLE INFO Article history: Received 16-06-2021 Accepted 02-09-2021 Available online 26-11-2021 Keywords: Brown-Séquard syndrome Case report Hemicord myelitis Hemiparesis Pregnancy ABSTRACT Brown-Séquard syndrome is an incomplete spinal cord lesion characterized by hemisection injury of the cord. We present a case of pregnancy, delivery and postpartum course following this rare neurological condition. A 42-year-old woman presented with past history of idiopathic hemicord myelitis leading to right sided hemiplegia with decreased contralateral sensation of pain and temperature, consistent with Brown- Séquard syndrome, which was treated with steroids and Therapeutic Plasma Exchange. Thereafter, she had near-complete motor recovery and complete sensory recovery over the next 3months. Three years later, she presented to us at 37+2 weeks of gestation with residual hemiparesis with motor power grade of 4/5 in right upper and lower limbs. She underwent Caesarean section for breech presentation, which was done under general anaesthesia in view of prior spinal cord lesion. She was discharged for follow-up in Neurology outpatient clinic and physical rehabilitation. At follow up after 12 months of delivery, she had complete motor and sensory recovery. Management of spinal cord lesions in pregnancy and delivery requires specialist multidisciplinary care due to risk of medical and obstetric complications. This case demonstrates a rare scenario of a primigravida at term gestation with residual deficits of a past spinal cord lesion. This is an Open Access (OA) journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. For reprints contact: reprint@ipinnovative.com 1. Introduction Women with spinal cord lesions pose unique challenges during pregnancy. Improved rehabilitative care and advent of assisted reproductive techniques has increased the number of such patients presenting for obstetric care. Depending on the completeness of the spinal cord lesions, these patients maybe at higher risk for medical complications like urinary tract infections, venous thrombosis, pressure sores and autonomic dysreflexia (AD) and obstetric complications like preterm labour and higher rate of caesarean section. 1,2 Brown-Séquard syndrome is an incomplete spinal cord lesion resulting from hemisection of the spinal cord. It presents with varying severity of ipsilateral motor * Corresponding author. E-mail address: livelife.sb@gmail.com (S. Bharathi). weakness and loss of pain and temperature sensation on the contralateral side. 3 As it is a rare entity, there is very limited literature on management of patients with Brown Sequard syndrome in pregnancy with only 2 such cases reported so far. 4,5 We report a case of a 42-year-old woman at 37+2 weeks of pregnancy with residual hemiparesis from a nontraumatic Brown Sequard syndrome which had occurred 3 years ago. The patient underwent caesarean section in view of breech presentation and had an uneventful course in the hospital. She was advised postnatal thromboprophylaxis and outpatient Neurology follow-up with physical rehabilitation. https://doi.org/10.18231/j.ijogr.2021.117 2394-2746/© 2021 Innovative Publication, All rights reserved. 572