Barré-Lieou syndrome
| Classification according to ICD-10 | |
|---|---|
| M53.0 | Cervicocephalic syndrome |
| ICD-10 online (WHO version 2019) | |
The Barre Lieou syndrome (also: Zervikozephales Syndrome ) is a disease of the autonomic nervous system and the cervical spine . It is named after the Strasbourg neurologist Jean-Alexandre Barré (1880–1967).
Symptoms
It comes to headaches and dizziness , sometimes to neck pain . In addition, there are sometimes hearing and visual disorders such as eye flickering , pain in the eye socket, but also difficulty swallowing and choking . The mobility of the cervical spine is often restricted, especially when it comes to turning. Often pain in the back of the head occurs, which can be unilateral or bilateral and dependent on movement and position. Often times they manifest after waking up. Low blood pressure and circulatory disorders as well as psychological disorders also occur. In addition, nerve deficits with motor paralysis , sensory disturbances, tingling, etc. can occur.
Not all muscle tension causes chronic cervicocephalic syndrome. However, a recurrent blockage accompanied by a protective spasm can be interpreted as a sign of a compensatory reaction for an existing ligamentous or capsular insufficiency in the sense of a mono- or polysegemental cervical spine instability.
causes
Various diseases of the cervical spine, signs of wear and tear, and neurological diseases as well as local nerve irritation are possible causes .
Aetiologically it should be noted that this clinical picture is predominantly vertebrobasilar symptoms as well as symptoms that are causally related to brain stem and cerebellar functions. Therefore, a cervical vertebral slippage, a so-called cervical spondylolisthesis (ICD M43.11, M43.12) with mechanical medullary irritation or vascular disorders such as recurrent occlusion of the vertebral arteries with the consequence of intermittent VBI symptoms (arteria-vertebralis Compression syndrome) or disturbances of the venous outflow through the vertebral vein or the jugular vein in the presence of a cervical spine instability. This hypothesis is confirmed because one group of patients regularly reports that the symptoms appear most intensely after vegetative rest and relaxation phases. This can be explained by a reduction in protective spasm in the presence of cervical spine instability and mechanical or vascular decompensation. In Barre Lieou patients, glucose utilization PET repeatedly demonstrated insufficient perfusion in the vertebrobasilar supply area in the sense of diffuse-hypoxic damage. Contrary to common medical opinion, the vertebrobasilar area can hardly be compensated by the circulus arteriosus cerebri, as this would have to be accompanied by a flow reversal in the area of the vertebral arteries. This occurs mainly in subclavian steal syndrome and is described as a cardinal symptom with drop attacks, i.e. the loss of perfusion volume in the area of the brain stem.
Causes are injuries , inflammation of the vertebral bodies , tumor diseases in the area of the spine and rheumatic diseases . There is controversy as to whether ligamentous insufficiencies after the administration of quinolones (gyrase-inhibiting antibiotics) can be named as the cause of this clinical picture.
treatment
Physical therapy and physiotherapy , but also electrotherapy , progressive muscle relaxation and heat applications can be used. If there is evidence of ligamentous insufficiency, Hewitt's proliferation therapy (The Spine Journal 5 (2005) 310-328) or surgical stabilization may be considered to provide relief or healing. In the case of acute complaints, painkillers are administered and the cervical spine is relieved by a cervical collar . Surgical procedures are only carried out when all other therapies fail.
prevention
The one-sided stress and bad posture in work and leisure are to be avoided. Breaks should be taken when working regularly overhead. Regular exercise can prevent the disease.
