What is Barre Syndrome – Liue?
With this disease, pain associated with pathological changes in the I-II and II-III cervical vertebrae is noted.
Pathogenesis during Barre Syndrome – Liue
In its pathogenesis, in addition to compression of the roots of the spinal nerves with the subsequent development of venous stasis and edema of the nervous structures, the involvement of the vegetative components of the sympathetic nerve fibers of the second and third cervical nerves is important. This, in turn, strengthens and fixes for a certain time the insufficiency of regional blood circulation not only in the zone of arthritic changes, but also in the nuclei of the cranial nerves of the cerebellopontine region, which causes the clinical symptoms of the syndrome.
Symptoms of Barre Syndrome – Liue
The classic signs of the syndrome are described: pain in the back of the head and face, dizziness or instability when standing and walking, noise and pain in the ears, visual disturbances and accommodation, pain in the eye area, decreased retinal vascular tone. In addition, with this syndrome, there may be pharyngeal disorders – glossitis with a progressive course, as well as mental changes manifested by excitement.
Pain in the occiput and face due to irritation of the occipital nerve. Dizziness is the result of irritation of the superior cervical ganglion and its connecting branches. With this syndrome, dizziness is noted with a sudden change in the body, for example, when getting out of bed after sleep or a sharp turn of the head to the side. It passes quickly if the patient again takes a horizontal position and again gets up, but at a slower pace.
Sensory disturbances – hearing loss, tinnitus, visual impairment – depend to a large extent on involvement in the autonomic nervous system and impaired regional blood supply. A characteristic feature of eye symptoms in Barre-Lieu syndrome is a feeling of sinking eyes or pain behind the eyes.
Diagnosis of Barre Syndrome – Liue
Differential diagnosis
Barre-Lieu syndrome should be distinguished from Meniere’s syndrome. At the first, vestibular disorders are not observed.
Treatment for Barre Syndrome – Liue
The treatment is complex. Severe manifestations of the disease (sharp headaches, dizziness with nausea and vomiting, radicular pain syndrome, transient cerebrovascular accident) require hospitalization of the patient. In acute radicular pain, a bed rest is prescribed for 3 days and a half-bed rest for 3-5 days. Of great importance is the position of the patient in bed: on the back, with a low small pillow, a bag with heated sand can be placed under the neck, which will provide dry heat and fixation of the cervical spine in the most convenient position. In the future, physiotherapy is recommended: diadynamic and sinusoidal modulated currents, electrophoresis of solutions of aminophylline, dipyrone (on the back of the neck, shoulder girdle), magnetotherapy, phonophoresis of hydrocortisone. At all stages of the process for pain, an alternating magnetic field in a pulsating mode is recommended. If it is not possible to carry out physiotherapy, mustard plasters and ointments are used (efkamon, nikoflex, finalgon, indomethacin ointment, etc.). Applications of dimexide with indomethacin or naproxen dissolved in it are shown for 40-50 minutes. With very severe pain, a mixture of chlorpromazine, diphenhydramine and dipyrone is administered intramuscularly. Immobilization of the cervical spine with a quilted soft collar is recommended. Correction of vascular disorders by intravenous and intramuscular administration of vasoactive drugs (aminophylline, cavinton, pentoxifylline, sermion, xanthinol nicotinate) is necessary, cinnarizine (stugeron), as well as ganglion blockers (gangleron) in combination with sibazonum are prescribed. After the acute pain subsides, you can use radon, coniferous or mineral baths, massage, low-temperature mud applications. With persistent pain, reflexology sometimes has an effect. Indomethacin, ortofen, naproxen, piroxicam, etc. are also used. Neurosis-like syndrome is an indication for the appointment of tranquilizers and antidepressants (chlozepide, mezapam, mebicar, phenibut, sibazon, azafen, amitriptyline, etc.). In complex treatment take into account the fact that P. n. from. may be aggravated by the influence of infectious, toxic, allergic and other factors.
Therapeutic gymnastics is prescribed only after a decrease in pain. At the same time, the patient’s age, the severity of osteochondrosis and its clinical manifestations, the presence of concomitant diseases are taken into account. Rotational movements in the cervical spine are contraindicated, especially for the elderly, as well as tipping the head with an oversized spine. A physical therapy session usually lasts from 5 to 30 minutes and includes exercises to strengthen the muscles of the neck, trapezius muscles, decompression of the roots, which is created by stretching the neck in a sitting position, standing and lying with an arbitrary muscle tension. Treatment with passive stretching should be carried out very carefully, because it may aggravate headache and dizziness. Traction is contraindicated in the elderly, with atherosclerosis of cerebral vessels, hypertension, chronic circulatory failure in the vertebrobasilar pool.
Without exacerbating the disease, sanatorium-resort treatment is indicated, which includes hydrogen sulfide, radon or pearl baths, mud, massage, exercise therapy, as well as the use of vasoactive drugs. Recommended anti-relapse treatment, follow-up, rational employment.