Barré-Lieu syndrome

The disease that occurs due to compression of the nerve endings located around the vertebral artery is called Barre-Lieou syndrome. The pathology was first described in the last century: at that time it was given the name "cervical migraine", since one of the main symptoms of the disease is one-sided pain of the migraine type.

Causes Barre-Lieu syndrome

The causes of the disease are considered to be damage to 1-3 cervical vertebrae, which leads to compression of the spinal nerve endings located by the poison. As a result, blood circulation and lymph flow are disrupted in this area.

As a result of the above pathological processes, tissue edema is formed, which further increases the compression of the nerves. At the same time, the vertebral artery is also compressed, which leads to deterioration of cervical and cerebral blood circulation.

Common causes of Barré-Lieou syndrome include inflammatory processes in the subarachnoid membrane, inflammation of the lymph nodes of the cervical region, arterial atherosclerosis, or compression of the vertebral artery.

[ 1 ]

Pathogenesis

The pathogenesis of the syndrome consists, in addition to compression of the spinal nerve endings, in the involvement of the autonomic nervous system associated with the second and third cervical nerves in the pathological process. As a result, a persistent deficit of regional blood circulation is established, both in the affected area and in the cranial nerves in the area of the pons and cerebellum.

[ 2 ], [ 3 ]

Symptoms Barre-Lieu syndrome

The first signs of the syndrome are quite specific and are constant pain in the head, often pulsating. The pain is localized in the neck and back of the head, sometimes affecting the back of the head. In many cases, this condition is associated with a common migraine, which explains the long-standing name of Barre-Lieou syndrome - "cervical migraine".

Clinical variants of the course of the syndrome allow it to be divided into stages:

• The functional stage is accompanied by headache with vegetative symptoms, including cochleovestibular and visual dysfunction. This is manifested by paroxysmal dizziness (unsteadiness), hearing loss, the appearance of "flies" before the eyes, and a sensation of a foreign body in the eyes.
• The organic stage is characterized by the appearance of signs of transient and hemodynamic disorder:
  • dizziness, dyspepsia, nausea;
  • ischemic attacks with head movements that last up to 10 minutes.

Forms

According to clinical symptoms, certain types of Barré-Lieou syndrome can also be distinguished.

• Posterior cervical sympathetic syndrome of Barre-Lieou occurs with pain in the back of the head and neck, which can radiate to the frontal region. The pain intensifies in the morning after waking up (the feeling of an "uncomfortable pillow"), after a long walk, travel by transport, physical exertion. The nature of the pain is pulsating, tingling. Often the condition is aggravated by visual and vestibular disorders.
• Basilar migraine is a consequence not of compression, but of spasm of the vertebral artery, which manifests itself as a sudden paroxysmal headache with vomiting, dizziness and subsequent fainting.
• The manifestations of vestibulocochlear syndrome are:
  • tinnitus;
  • change in pain intensity with head movements;
  • deterioration in perception of quiet speech;
  • dizziness.
• Ophthalmic syndrome is primarily characterized by visual impairment (flickering, loss of visual fields, deterioration of visual perception). In addition, there are signs of conjunctival inflammation, such as lacrimation and redness of the eyes.
• Vegetative syndrome occurs in combination with other syndromes listed above. It is characterized by sensations of temperature changes, sweating, sleep and sleep disorders, skin manifestations.
• Transient ischemic attack syndrome is manifested by paroxysmal disorders in the form of nausea, disturbances of consciousness and speech, dysphagia, and diplopia.
• Syncopal-vertebral syndrome is a sudden circulatory disorder that affects the functioning of the autonomic nervous system. One of the characteristic symptoms is a short-term fainting spell with a sharp head movement.
• Episodic drop attack syndrome is associated with impaired blood flow in the caudal parts of the hemispheres, a symptom of which is transient, short-term paralysis of the arms and legs after throwing the head back.

[ 4 ], [ 5 ]

Complications and consequences

If a disease such as Barre-Lieou syndrome is not treated, or is treated incorrectly, the following negative consequences may occur:

• A disorder of blood circulation in certain areas of the brain. This complication initially manifests itself as a temporary ischemic attack, which then develops into a stroke with all the ensuing deterioration of the condition.
• Fainting, coordination disorders, loss of working capacity and inability to take care of oneself independently. As a result – disability.

[ 6 ], [ 7 ]

Diagnostics Barre-Lieu syndrome

Diagnosis is usually based on information the doctor receives from the patient's complaints and external neurological examination. Often the doctor finds tension in the muscles of the back of the head, problems with head movements, and pain when pressing on the first and second cervical vertebrae.

In addition to the above, other diagnostic measures may be carried out.

• Instrumental diagnostics:
  • X-rays in various projections make it possible to detect abnormalities in the atlanto-occipital joint, as well as other factors that provoke compression of the vertebral artery;
  • Dopplerography method – allows to assess the degree of deterioration of blood supply to vessels;
  • MRI of the brain – helps to determine the cause of ischemia and accurately localize the site of vascular compression.

Blood or urine tests (laboratory studies) are of little use in Barré-Lieou syndrome.

Differential diagnosis

Differential diagnosis is carried out with common migraine, Meniere's syndrome and cervical osteochondrosis.

[ 8 ], [ 9 ], [ 10 ], [ 11 ]

Treatment Barre-Lieu syndrome

Treatment of Barre-Lieou syndrome cannot be one-sided. A comprehensive therapeutic regimen is prescribed taking into account the patient's age, the degree of the disease and the individual characteristics of the patient.

To prevent the development of ischemia, treatment measures are primarily aimed at eliminating compression and circulatory disorders.

Based on the diagnostic results, the doctor can create a treatment plan using several different methods.

Medicines are prescribed to eliminate the cause of Barre-Lieou syndrome and alleviate the patient's condition. Painkillers, nonsteroidal anti-inflammatory drugs, and medications that improve blood flow to the brain are usually prescribed.

	Dosage	Side effects	Special instructions
Ketorol	Take 10 mg up to 4 times a day. Duration of administration is no more than 5 days.	Diarrhea, gastritis and stomach ulcers, pain in the kidney area, hearing loss, tinnitus, high blood pressure, anemia.	Should not be used to treat children under 16 years of age.
Baralgin	Take 1-2 tablets up to 3 times a day, but not more than 5 days in a row.	Allergic reactions, impaired renal function, pink urine, decreased blood pressure.	Do not use for kidney disease, low blood pressure, or for treating patients with chronic alcoholism.
Movalis	Prescribed in a dosage of up to 15 mg per day.	Anemia, abdominal pain, dyspepsia, discomfort at the injection site.	Should not be used concomitantly with other nonsteroidal anti-inflammatory drugs.
Cinnarizine	Take after meals, 2 tablets three times a day.	Fatigue, trembling in the arms and legs, thirst, dyspepsia, increased sweating, skin rashes.	During treatment, you should refrain from drinking alcohol.

It is also important to use medications that improve energy processes in the brain and alleviate symptoms. Cholinergic agents (for example, gliatilin), muscle relaxants (mydocalm), and antimigraine agents are commonly prescribed for this purpose.

Read also:

• Pain relief creams
• Effective ointments for neck pain

Vitamins play a special role in Barre-Lieou syndrome. It is no secret that many vitamin preparations stabilize the nervous system and prevent the effects of stress. Moreover, vitamin group B can normalize the level of serotonin in the body.

• Thiamine – to some extent relieves pain, improves blood flow, eliminates headaches and increased irritability.
• Riboflavin – reduces the frequency and severity of migraine attacks. It has been proven experimentally that only this vitamin can reduce the number of attacks by about 35%.
• Nicotinic acid – facilitates the work of the nervous system, promotes vasodilation, alleviating the manifestations of the syndrome.
• Pyridoxine – participates in the regulation of brain activity, partly acts as an antidepressant.
• Cyanocobalamin – supports the functioning of the entire nervous system.

In addition to vitamins, magnesium is necessary for the normal functioning of the nervous system and normalization of vascular tone. The main actions of magnesium are improving metabolic processes in the brain, dilating blood vessels, protecting against stress, etc.

It is better to choose complex vitamin preparations that contain all the necessary vitamins and minerals, as they complement each other advantageously, which provides a lasting cumulative effect.

Physiotherapy treatment for Barre-Lieou syndrome includes:

• the use of a special Shantz collar, which reduces the load on the spine, or more precisely, on its cervical region. The collar has individually selected sizes;
• acupuncture and reflexology help reduce pain, eliminate dizziness, and calm the patient;
• Additionally, magnetic therapy, electrophoresis, diadynamic therapy (Bernard currents), and exercise therapy are prescribed.

Homeopathy is prescribed only after the exact causes of Barre-Lieou syndrome have been determined. Only then can significant benefits from the drugs be expected.

For constant pain, it is recommended to use dilution C6-C12. The medicine is taken in quantities of 6 to 8 granules up to 3 times a day. Duration of administration - until the condition improves.

• Arnica - helps with pressure pain, brain injuries, as well as pain that depends on the position of the head or emotional state.
• Bryonia is suitable for patients with pulsating and twitching pains, which are accompanied by bouts of vomiting and dyspepsia.
• Chamomilla - used to relieve the condition of patients who are particularly sensitive to any pain.
• Cocculus - can be prescribed for pain in the occipital region, which is combined with dizziness and sleep disturbances.
• Veratrum - will be effective for pain that is accompanied by loss of consciousness, sweating, especially when tilting the head or body forward.

A homeopathic doctor may prescribe other remedies that are not on our list. The fact is that homeopathic remedies are always used according to individual indications, and, in addition, they can have both therapeutic and preventive properties.

Surgical treatment for Barre-Lieou syndrome is used only if there is diagnostically proven significant compression of the vessels, and conservative therapy does not bring the expected effect. Compression of the vessels can occur due to compression by osteophytes or a pathological neoplasm. Depending on the cause of this condition, either the osteophyte is removed or the tumor is resected.

It is also possible to perform sympathectomy – a surgical intervention to remove a certain part of the sympathetic division of the autonomic nervous system.

Folk remedies

Traditional methods that can be used to alleviate the condition of Barre-Lieou syndrome are quite diverse. For example, the following traditional medicine recipes, tested by time, can be recommended:

• Apply hot compresses to the back of the head and neck.
• Practice a contrast shower every morning.
• During an attack, drink hot tea with lemon.
• Perform self-massage of the head with both hands, from the back of the head to the temples.
• During an attack, inhale an alcohol mixture of ammonia and camphor alcohol.
• Apply compresses of raw grated onion to the back of the head.

Herbal treatment usually complements traditional therapy. The patient's condition can be improved by using the following recipe options:

• Prepare a mint infusion from 250 ml of boiling water and 1 full teaspoon of dry mint leaves. Infuse for 20 minutes. Drink 1/3 cup three times a day half an hour before meals.
• Take pasque flower herb (2 tsp), pour 250 ml of hot water and leave overnight. Strain in the morning and drink little by little throughout the day.
• Prepare an infusion of elder flowers - 250 ml of boiling water per 1 tbsp of flowers. Infuse for 30 minutes, filter. Drink the infusion with honey, 50-75 ml three times a day before meals.

[ 12 ], [ 13 ]

Prevention

To prevent the occurrence of Barre-Lieou syndrome, it is recommended to maintain the health of the spinal column, since the absence of disorders on the part of the spine practically guarantees that the disease will not occur.

It is useful to do exercises to strengthen the back muscles, try to maintain correct posture, avoid back injuries and eat a balanced diet.

Food should not contain a large amount of salt, and the balance of proteins, lipids and carbohydrates should be maintained as much as possible. The presence of sufficient vitamins and minerals in food is also of great importance. All these recommendations will help maintain the health of the intervertebral discs and the entire spine as a whole.

[ 14 ], [ 15 ], [ 16 ]

Forecast

The prognosis for Barré-Lieou syndrome depends on the degree and cause of vertebral artery compression, as well as the extent of medical care provided.

In the most unfavorable scenario, the patient may become disabled.

The difficulty often lies in the fact that Barre-Lieou syndrome is not recognized in a timely manner. Sometimes precious time is lost, and unwanted complications may develop. Therefore, it is very important to contact doctors in a timely manner and undergo all prescribed stages of treatment.