Barre-Lieou Syndrome
What is Barre-Lieou Syndrome?
Barre-Lieou syndrome is a rare and poorly understood condition associated with irritation or dysfunction of the cervical sympathetic nerves in the neck, often resulting in a range of neurological and vascular symptoms. There are three cervical sympathetic nerve bundles that link the upper spinal cord to the base of the skull: the superior, middle, and inferior cervical chains. The sympathetic nerves are responsible for autonomic processes, or bodily processes such as ‘fight or flight’ that are automatic responses. Barre-Lieou syndrome is frequently linked to cervical spine abnormalities, particularly degenerative changes or trauma, which can compress or affect the nerves and blood vessels in the region. Symptoms include headaches, neck pain, dizziness, and vision disturbances, often mimicking other neurological disorders.
Synonyms
- Posterior cervical sympathetic syndrome
- Cervical sympathetic syndrome
Barre-Lieou syndrome is a rare and poorly understood condition associated with irritation or dysfunction of the cervical sympathetic nerves in the neck, often resulting in a range of neurological and vascular symptoms. There are three cervical sympathetic nerve bundles that link the upper spinal cord to the base of the skull: the superior, middle, and inferior cervical chains. The sympathetic nerves are responsible for autonomic processes, or bodily processes such as ‘fight or flight’ that are automatic responses. Barre-Lieou syndrome is frequently linked to cervical spine abnormalities, particularly degenerative changes or trauma, which can compress or affect the nerves and blood vessels in the region. Symptoms include headaches, neck pain, dizziness, and vision disturbances, often mimicking other neurological disorders.
The prevalence of Barre-Lieou syndrome is unknown, but it is considered rare. The condition is thought to be underdiagnosed due to symptom overlap with other disorders, such as migraines, cervical spine diseases, and autonomic dysfunction. It affects both men and women and is most commonly seen in middle-aged adults.
| Name | Abbreviation |
|---|---|
| Posterior cervical sympathetic syndrome | |
| Cervical sympathetic syndrome |
The exact cause of Barre-Lieou syndrome is not fully understood, but it is believed to arise from dysfunction or irritation of the cervical sympathetic nerves due to:
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Degenerative Cervical Spine Changes: Conditions like cervical spondylosis or intervertebral disc herniation can cause mechanical irritation.
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Trauma: Whiplash injuries from motor vehicle accidents or other neck injuries may trigger the condition.
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Postural Issues: Poor posture or prolonged stress on the cervical spine can contribute to nerve dysfunction.
Other Factors: Vascular compression, autoimmune processes, or infections may also play a role in some cases.
The symptoms of Barre-Lieou syndrome are varied and can affect multiple systems, including:
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Head and Neck Symptoms: Persistent neck pain, headaches (often at the base of the skull), and occipital neuralgia.
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Dizziness and Vertigo: Episodes of lightheadedness or a spinning sensation, especially with head movement.
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Vision Disturbances: Blurred vision, photophobia (sensitivity to light), and visual field deficits.
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Hearing Issues: Tinnitus (ringing in the ears), ear fullness, or hearing loss.
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Autonomic Symptoms: Sweating, facial flushing, or difficulty swallowing due to autonomic nerve involvement.
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Neurological Symptoms: Numbness or tingling in the arms and shoulders, and in some cases, anxiety or mood changes.
Barre-Lieou syndrome is primarily a clinical diagnosis based on symptom patterns and the exclusion of other conditions. Its diagnosis is complicated by the lack of specific diagnostic criteria or biomarkers. A detailed medical history, physical examination, and imaging studies are essential to rule out other causes of similar symptoms.
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Imaging Studies: X-rays, MRI, or CT scans of the cervical spine may reveal degenerative changes, disc herniation, or other structural abnormalities.
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Nerve Conduction Studies: These tests may assess the function of cervical nerves and help rule out other neurological disorders.
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Doppler Ultrasound: May be used to evaluate blood flow in the cervical vessels if vascular compression is suspected.
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Autonomic Function Tests: Assessing the autonomic nervous system can help identify dysfunction associated with Barre-Lieou syndrome.
Treatment for Barre-Lieou syndrome is typically symptomatic and focuses on relieving pain and improving quality of life:
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Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, or nerve pain medications such as gabapentin may be used for symptom control.
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Physical Therapy: Neck strengthening and stretching exercises can help improve posture and reduce nerve irritation.
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Chiropractic Care: Manual adjustments may provide relief for some individuals, though care should be taken to avoid exacerbating symptoms.
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Nerve Blocks: Local anesthetic injections near the cervical sympathetic nerves may temporarily alleviate symptoms in some cases.
Surgery: In severe cases involving structural abnormalities, surgical decompression of the affected nerves or cervical spine may be considered.
The prognosis for Barre-Lieou syndrome varies depending on the underlying cause and response to treatment. Many individuals experience significant symptom relief with appropriate management, though some may have persistent or recurrent symptoms. The condition is not life-threatening but can substantially impact quality of life if untreated. Early diagnosis and a multidisciplinary approach to care improve outcomes for most patients.
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After these steps, the enrollment process is complete. All other questions are voluntary. However, these questions are important to patients and their families to create awareness as well as to researchers to study rare diseases. This is why we ask our participants to update their information annually or anytime changes to their information occur.
Researchers can contact CoRDS to determine if the registry contains participants with the rare disease they are researching. If the researcher determines there is a sufficient number of participants or data on the rare disease of interest within the registry, the researcher can apply for access. Upon approval from the CoRDS Scientific Advisory Board, CoRDS staff will reach out to participants on behalf of the researcher. It is then up to the participant to determine if they would like to join the study.
Visit sanfordresearch.org/CoRDS to enroll.
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