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The Barre-Liège syndrome

 

The disease that occurs on the soil of the compression of nerve endings located around the vertebral artery is called the Barre-Liège syndrome. For the first time the pathology was described in the last century: at that time it was called "cervical migraine", since one of the main symptoms of the disease is unilateral pain in the type of migraine.

Causes of the the Barre-Liège syndrome

The causes of the disease is considered to be a lesion of 1-3 vertebrae of the cervical region, which leads to the transmission of poisonous ends of the spinal nerves. As a consequence, blood circulation and lymph flow are disturbed in this zone.

As a result of the above pathological processes, swelling of the tissues is formed, which further increases the compression of the nerves. At the same time, the vertebral artery is compressed, which leads to worsening of the cervical and cerebral circulation.

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

Pathogenesis

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

Symptoms of the the Barre-Liège syndrome

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

Clinical variants of the syndrome can be divided into stages:

  • The functional stage is accompanied by a headache with autonomic symptoms, including cochleovestibular and visual dysfunction. This is manifested by paroxysmal dizziness (instability), hearing loss, appearance of "flies" before the eyes, 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, attacks of nausea;
    • ischemic attacks with head movements, which last up to 10 minutes.

Forms

According to clinical symptoms, it is also possible to identify certain types of the Barre-Liège syndrome.

  • The prehospital sympathetic syndrome of Barre-Lieu proceeds with pains in the neck and neck, which can give to the frontal region. The pain intensifies in the morning after awakening (sensation of "inconvenient pillow"), after a long walk, transportation trips, physical exertion. The nature of pain is pulsating, tingling. Often the condition is aggravated by visual and vestibular disorders.
  • Bazillar migraine is a consequence of not squeezing, but spasm of the vertebral artery, which is manifested by a sudden seizure headache with vomiting, dizziness and subsequent fainting.
  • Manifestations of vestibulohohlearnogo syndrome are:
    • noise in ears;
    • change in the intensity of pain when moving head;
    • deterioration of the perception of quiet speech;
    • dizziness.
  • Ophthalmic syndrome, in the first place, is characterized by impairment of visual function (flickering, loss of visual fields, impaired visual perception). In addition, there are signs of inflammation of the conjunctiva, such as teardrops, redness of the eyes.
  • Vegetative syndrome occurs in combination with other aforementioned syndromes. It is characterized by sensations of temperature drop, sweating, sleep disorders and falling asleep, skin manifestations.
  • The syndrome of transient ischemic attacks is manifested by paroxysmal disturbances in the form of nausea, frustration of consciousness and speech, dysphagia, diplopia.
  • Syncopal-vertebral syndrome is a sudden circulatory disorder that affects the functioning of the autonomic nervous system. One of the characteristic features - a brief faint with a sharp head movement.
  • The syndrome of episodic drop-attacks is associated with worsening of the blood flow in the caudal hemispheres, the symptom of which is a transient non-prolonged paralysis of the hands and feet after the head is thrown backwards.

Complications and consequences

If a disease such as Barre-Liège syndrome does not respond to treatment or is illiterate, the following negative consequences can occur:

  • Disturbance of blood circulation in certain areas of the brain. This complication first manifests itself as a temporary ischemic attack, which then goes into a stroke with all the resulting deterioration of the condition.
  • Fainting, coordination disorders, loss of efficiency and inability to service yourself. As a result - disability.

Diagnostics of the the Barre-Liège syndrome

Diagnosis is usually based on information that the doctor receives, based on patient complaints and external neurological examination. Often the doctor discovers the tension of the neck muscles, problems with the movements of the head, soreness when pressing on the first and second cervical vertebrae.

In addition to the above, it is possible to conduct other diagnostic activities.

  • Instrumental diagnostics:
    • X-ray diffraction in various projections makes it possible to detect abnormalities in the atlanto-occipital joint, as well as other factors that provoke compression of the vertebral artery;
    • method of dopplerography - allows you to assess the degree of deterioration of the blood supply of blood vessels;
    • MRI of the brain - helps to determine the cause of ischemia and precisely localize the place of vascular compression.

Analyzes of blood or urine (laboratory tests) with the Barre-Liège syndrome are poorly informative.

What do need to examine?

Differential diagnosis

Differential diagnosis is performed with a common migraine, Meniere's syndrome and cervical osteochondrosis.

Treatment of the the Barre-Liège syndrome

Treatment of the Barre-Liège syndrome can not be one-sided. The complex therapeutic scheme is appointed taking into account the patient's age, degree of disease and individual characteristics of the patient.

In order to prevent the development of ischemia, medical measures are firstly directed to the elimination of compression and circulatory disorders.

Based on the results of the diagnosis, the doctor can draw up a treatment regimen using several different methods.

Medications are prescribed to eliminate the cause of the Barre-Liège syndrome and alleviate the condition of the patient. Usually prescribed painkillers, non-steroidal anti-inflammatory drugs, as well as medications that improve the blood supply to the brain.

Dosage

Side effects

Special instructions

Ketorol

Take 10 mg to 4 times a day. Duration of reception - no more than 5 days.

Diarrhea, gastritis and stomach ulcer, pain in the kidney, hearing loss, tinnitus, increased blood pressure, anemia.

Can not be used to treat children under 16 years old.

Baralgin

Take 1-2 tablets up to 3 times a day, but not more than 5 days in a row.

Allergic manifestations, impaired renal function, staining the urine in pink, lowering blood pressure.

Do not use in diseases of the kidneys, under reduced pressure, and also for the treatment of patients with chronic alcoholism.

Movalis

Assign a dosage of up to 15 mg per day.

Anemia, abdominal pain, dyspepsia, discomfort at the injection site.

Do not use concomitantly with other non-steroidal anti-inflammatory drugs.

Cinnarizine

Take after meals, 2 tablets three times a day.

Fatigue, trembling in the hands and feet, thirst, dyspepsia, increased sweating, rashes on the skin.

For the duration of treatment should be discarded from drinking alcohol.

It is also important to use medicines that improve the energy processes in the brain, and also relieve symptoms. For this purpose, it is customary to prescribe cholinergic agents (eg, gliatilin), muscle relaxants (midol), antimigraines.

Read also:

The vitamins in the Barre-Liège syndrome play a special role. It's no secret that many vitamin preparations stabilize the nervous system and prevent stress. Moreover, the vitamin B group can normalize serotonin levels in the body.

  • Thiamine - to some extent, anesthetizes, improves blood flow, eliminates headache and increased irritability.
  • Riboflavin - reduces the frequency and strength of migraine headaches. It has been proven by experience that only this vitamin can reduce the number of seizures by about 35%.
  • Nicotinic acid - facilitates the work of the nervous system, promotes vasodilation, facilitating the manifestation of the syndrome.
  • Pyridoxine - is involved in the regulation of brain activity, partly an antidepressant.
  • Cyanocobalamin - supports the work of the entire nervous system.

In addition to vitamins, normal functioning of the nervous system and normalization of vascular tone require magnesium. The main actions of magnesium - is the improvement of metabolic processes in the brain, vasodilation, protection from stress, etc.

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

The physiotherapeutic treatment of the Barre-Liège syndrome includes:

  • The use of a special collar of Shantz, which reduces the load from the spine, or rather, from its cervical region. The collar is individually sized;
  • Acupuncture and reflexotherapy helps to reduce pain, eliminate dizziness, calm the patient;
  • In addition, magnetotherapy, electrophoresis, diadynamic therapy (Bernard's currents), exercise therapy are prescribed.

Homeopathy is prescribed only after determining the exact causes of the Barre-Liège syndrome. Only in this case can we expect a significant benefit from the drugs.

With constant pain, it is recommended to use dilution C6-C12. Medicines take in the amount of 6 to 8 granules up to 3 times a day. Duration of admission - until the condition improves.

  • Arnica - helps with pressing pain, brain trauma, and also pain, depending on the position of the head or emotional state.
  • Bryonia - suitable for patients with pulsating and twitching pains, which are accompanied by bouts of vomiting and dyspepsia.
  • Hamomilla - is used to relieve the condition in patients who are particularly sensitive to any pain.
  • Kokkulyus - can be prescribed for pain in the occipital region, which are combined with dizziness and sleep disorders.
  • Veratrum - will be effective for pains that are accompanied by loss of consciousness, perspiration, especially when the head or torso is tilted anteriorly.

The doctor-homeopathist can appoint and other means which are not present in the list offered by us. The fact is that homeopathic preparations are always used according to individual indications, and, besides, they can have both curative and preventive properties.

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

It is also possible to conduct sympathectomy - surgical intervention to remove a specific area of the sympathetic department of the autonomic nervous system.

Alternative treatment

Alternative methods that can be used to alleviate the condition with the Barre-Liège syndrome are quite diverse. For example, you can recommend the following recipes of alternative medicine, time-tested:

  • Apply hot compresses on the back of the head and neck.
  • Every morning, practice a contrast shower.
  • During an attack, drink hot tea with lemon.
  • To conduct a self-massage of a head with two hands, in a direction from a nape to temples.
  • During an attack, inhale the alcohol mixture from a solution of ammonia and camphor alcohol.
  • Apply compresses from raw grated onions to the occiput.

Herbal therapy usually complements traditional therapy. Improve the patient's condition can be, using such variants of recipes:

  • Prepare mint infusion of 250 ml of boiling water and 1 full teaspoon of dried mint leaves. Insist 20 minutes. Drink 1/3 cup three times a day for half an hour before meals.
  • Take the grass lumbago (2 tsp), pour 250 ml of hot water and insist for the night. In the morning, filter and drink a little throughout the day.
  • Prepare infusion of elderberry flowers - 250 ml of boiling water per 1 tbsp. L. Flowers. Insist 30 minutes, filter. Drink infusion with honey, 50-75 ml three times a day before meals.

Prevention

To prevent the emergence of the Barre-Liège syndrome, it is recommended to maintain the health of the spinal column, because the absence of disorders from the spine practically guarantees that the disease does not arise.

It is useful to perform exercises to strengthen the muscles of the back, try to maintain a correct posture, avoid back trauma and eat fully.

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

Forecast

The prognosis of the Barre-Liège syndrome depends on the degree and cause of the compression of the vertebral artery, and also on the scale of the medical care provided.

With the most unfavorable development of the event, the patient may become disabled.

The difficulty is often that the Barre-Liège syndrome is not recognized in a timely manner. Sometimes precious time is lost, and unwanted complications can develop. Therefore, it is very important to contact the doctors on time, and go through all the prescribed stages of treatment.

Last update: 25.06.2018
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Medical expert editor

Portnov Alexey Alexandrovich

Education: Kiev National Medical University. A.A. Bogomolets, Specialty - "General Medicine"

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