Even though this clinical term was introduced in medical literature almost 100 years ago, the pathogenesis and exact clinical definition remain obscure. It is assumed that symptoms in Barre-Lieou syndrome arise due to the stimulation of sympathetic ganglia and fibers situated in the posterior areas of the C3 and C4 segments of the spine as a result of their protrusion after neck trauma [1] [2]. Consequently, vasoconstriction of the vascular system, principally of the vertebral artery, and dysfunction of the posterior plexus is proposed as the etiology of symptoms [3] [4]. Tinnitus, vertigo, and dizziness developing on the grounds of ischemia of the inner ear are some of the most common complaints reported in the literature, as well as headaches, blurred vision, nausea, vomiting and pupillary dilation [3] [4] [5] may also occur. Other reports have associated the onset of visual deficits (blurred vision, corneal hyperaesthesia, and corneal ulceration), swallowing and respiratory difficulties, as well as pain and cervical muscle spasm (primarily of the sternocleidomastoid muscle) with Barre-Lieou syndrome, but also anxiety, depression, and arrhythmias [1] [2]. However, more recent studies have disputed the pathogenesis and the resultant appearance of symptoms, as sympathetic stimulation seems to have a minimal effect on the vascular resistance [3]. Moreover, the mentioned symptoms can often be present in many patients due to various other reasons, which is why frequently Barre-Lieou syndrome is not referred to as a distinct term in medicine [3] [5].

• Neck Weakness

  The patient said that the crepitation in his neck had decreased significantly and his main complaint was no longer pain, just neck weakness. He no longer needed to take tramadol or diazepam for pain. [caringmedical.com]

• Tinnitus

  From Wikidata Jump to navigation Jump to search syndrome that involves occipital head aches, nystagmus on head movement, tinnitus, spasms, blurred vision, corneal hyperaesthesia, and corneal ulcers Cervicocranial syndrome Cervicocranial syndrome (disorder [wikidata.org]

  Some symptoms include migraine pain, tinnitus, involuntary eye movements upon head movement (nystagmus), ringing in the ear (tinnitus), spasms, and blurred vision. [patientslikeme.com]

  Tinnitus, vertigo, and dizziness developing on the grounds of ischemia of the inner ear are some of the most common complaints reported in the literature, as well as headaches, blurred vision, nausea, vomiting and pupillary dilation may also occur. [symptoma.com]

  Type your tag names separated by a space and hit enter Authors Source MeSH Autonomic Nervous System Diseases Disease Headache Humans Neurologic Manifestations Posterior Cervical Sympathetic Syndrome Spinal Diseases Spine Sympathetic Nervous System Tinnitus [unboundmedicine.com]

• Otalgia

  Cephaelea (headache), otalgia (ear ache), dysphagia (difficulty swallowing), and even pain in the carotid artery can all be neurological symptoms of Barre-Lieou syndrome. [painneck.com]

  Tinnitus is common “In most cases tinnitus is unilateral; it may occur in association with some hearing loss and also with otalgia.” “Most patients suffer from marked asthenia.” [chiro-trust.org]

• Headache

  Together with a concomitant onset of dizziness, vertigo, visual disturbances and headaches, a presumptive diagnosis might be made. [symptoma.com]

  Browse Home / Headaches / Barre-Lieou Syndrome - JointRehab.com Although the common headache usually responds quite well to aspirin or other over the counter medications, those who’ve experienced the torment of migraines or cluster headaches are often [jointrehab.com]

  Treatment of Barre-Lieou Typically, headache sufferers take Cafergot, Ergotamine, and Sumatriptin, to relieve the migraine or cluster headache pain because these vasoconstrict the blood vessels. The medications are, at best, a temporary fix. [streetdirectory.com]

  Thus, the original works of Barré and Liéou were foundational in identifying a crucial feature which distinguishes cervicogenic headache from other headache syndromes—the concept that the pain originates from a structural abnormality in the cervical spine [en.wikipedia.org]

• Vertigo

  Together with a concomitant onset of dizziness, vertigo, visual disturbances and headaches, a presumptive diagnosis might be made. [symptoma.com]

  […] separated by a space and hit enter Authors Source MeSH Autonomic Nervous System Diseases Disease Headache Humans Neurologic Manifestations Posterior Cervical Sympathetic Syndrome Spinal Diseases Spine Sympathetic Nervous System Tinnitus Vertebral Artery Vertigo [unboundmedicine.com]

  She gets vertigo and stumbles and falls quite often. Her sinuses begin producing mucus and her right eye reddens (but not her left eye), and sometimes she says it feels as if the eye is being squeezed out of its socket. [medhelp.org]

  Symptoms include facial pain, chronic allergies, dizziness, neck pain, ear pain and vertigo. [ NCIT : P378 ] Synonyms: Barre-Lieou syndrome, posterior cervical sympathetic syndrome, Posterior cervical sympathetic syndrome, Cervicocranial syndrome, Posterior [ebi.ac.uk]

  PP clinical implications include cervicogenic migraine, vertigo, nausea, and the Barre-Lieou syndrome (10,13,15). [medical-dictionary.thefreedictionary.com]

• Dizziness

  Together with a concomitant onset of dizziness, vertigo, visual disturbances and headaches, a presumptive diagnosis might be made. [symptoma.com]

  Symptoms include facial pain, chronic allergies, dizziness, neck pain, ear pain and vertigo. [ NCIT : P378 ] Synonyms: Barre-Lieou syndrome, posterior cervical sympathetic syndrome, Posterior cervical sympathetic syndrome, Cervicocranial syndrome, Posterior [ebi.ac.uk]

  Barré-Liéou syndrome - irritation of a nerve plexus around a vertebral artery produces symptoms of dizziness, headache, tinnitus. [medical-dictionary.thefreedictionary.com]

  Symptoms that characterize the Barre-Lieou Syndrome: Headache, facial pain, ear pain, vertigo, tinnitus, loss of voice, hoarseness, neck pain severe fatigue, muscle weakness, sinus congestion, sense of eyeball being pulled out, dizziness, fatigue, numbness [streetdirectory.com]

• Paresthesia

  Pain assessment and management are required for paresthesias, hyperesthesias, muscle cramps, and deep muscle aches. [medical-dictionary.thefreedictionary.com]

  Sometimes the pain is accompanied by paresthesia in the form of feelings "tightening" of the head, "bulging" eyes, feeling cold, burning. [medicalency.com]

  Headaches were accompanied by other complaints like dizziness and vertigo, nausea, drop attacks, paresthesia, sight and hearing disturbances and also vegetative symptoms. [encephalos.gr]

  Pharyngeal paresthesias Laryngeal paresthesias Vertigo Shoulder-hand syndrome Acroparesthesia: (“a condition of burning, tingling, or pricking sensations or numbness in the extremities present on awaking and of unknown cause or produced by compression [chiro-trust.org]

  While parathesiae are usually blamed on direct nerve injury or irritation, thoracic outlet syndrome (which is probably an advanced manifestation of myofascitis) and sclertogenous pain can be associated with paresthesiae. [chiroweb.com]

• Cognitive Disorder

  Other symptoms (Neri) are anxiety, depression, and memory and cognitive disorders. (8) This non-specific constellation has been ascribed to trauma or arthritis of the third and fourth cervical vertebrae... [go.gale.com]

  Other symptoms (Neri) are anxiety, depression, and memory and cognitive disorders. 8 This non-specific constellation has been ascribed to trauma or arthritis of the third and fourth cervical vertebrae or disks, which in turn cause a disturbance of the [jnnp.bmj.com]

Because of the ambiguous interpretation of Barre-Lieou syndrome in medical practice, its diagnosis can be difficult to achieve. Having in mind the most important predisposing event - neck trauma [1] [4], a detailed patient history could identify injury or severe stretching of the neck. Together with a concomitant onset of dizziness, vertigo, visual disturbances and headaches, a presumptive diagnosis might be made. In addition, a detailed physical examination should be performed, with an emphasis on the range of motion of the head and neck area. Although plain radiography of the cervical spine is readily performed in the setting of neck-related injuries and associated symptoms, data regarding radiographic findings in patients suffering from Barre-Lieou syndrome are scarce, and rare reports have documented only a few patients demonstrating notable lesions (a tear drop fracture and ossification of the posterior longitudinal ligament) [4].

1. Pearce J. Barré-Liéou “syndrome.” J Neurol Neurosurg Psychiatry. 2004;75(2):319.
2. Longbottom J. A case report of postulated 'Barré Liéou syndrome'. Acupunct Med. 2005;23(1):34-38.
3. Li Y, Peng B. Pathogenesis, Diagnosis, and Treatment of Cervical Vertigo. Pain Physician. 2015;18(4):E583-595.
4. Tamura T. Cranial symptoms after cervical injury. Aetiology and treatment of the Barré-Liéou syndrome. J Bone Joint Surg Br. 1989;71(2):283-287.
5. Foster CA, Jabbour P. Barré-Lieou syndrome and the problem of the obsolete eponym. J Laryngol Otol. 2007;121(7):680-683.