Barré-Lieou syndrome and the problem of the obsolete eponym.

BACKGROUND: Eponym lists in major sources can give an aura of legitimacy to discredited diagnoses, as exemplified by the case of Barré-Lieou syndrome, a 'rare' vestibular disorder. METHODS: A literature review for information on the posterior cervical syndrome of Barré-Lieou. RESULTS: Barré-Lieou syndrome includes very common symptoms--tinnitus, dizziness, and head or neck pain--attributed to ischaemia caused by cervical sympathetic nerve compression. Its original description brings together many unrelated disorders, and its causative mechanism has been discredited. However, it appears credulously in a number of eponym lists, and references to the syndrome are steadily increasing on the internet in general and on alternative medicine and legal profession websites in particular. CONCLUSION: By inclusion in eponym lists, without a disclaimer, a syndrome can be given legitimacy before the general public. A syndrome, such as Barré-Lieou syndrome, that is useless to the medical profession can unfortunately prove to be very useful for litigants and disability claimants.

Lumbar spine fracture in a 34,100-year-old skeleton: the oldest known prehistoric spine fracture.

WE EXAMINED SPECIAL pathological changes of the lumbar spine from skeleton remains referred to as "Stetten 1," one of the earliest specimens of modern humans dating from the Early Stone Age (Upper Paleolithic). The skeleton was discovered during archaeological excavations under Riek in 1931 in the Vogelherd Cave near Stetten, close to the Lone Valley of southwestern Germany. The archaeological context is the so-called Aurignacian period (40,000-30,000 yr ago), representing the earliest cultural step of modern humans in Europe. Accelerator mass spectrometry with (14)C measurement yields a calibrated age of these remains averaging 34,100 years before the present. The L3-L4 vertebrae exhibit marginal bone fusion on the right side with a smooth surface. They show 20- to 30-degree kyphosis secondary to wedge impaction of the L4 vertebral body. The facet joints and vertebral bodies reveal small marginal osteophytes with even joint surfaces, indicating low degenerative changes. Stetten 1 is characterized by the presence of a healed lumbar spine fracture. It documents the earliest known case thus far of spine fracture among modern humans.

Spondylolysis and its relationship to degenerative joint disease in the prehistoric southeastern United States.

Spondylolysis, a fatigue fracture in the neural arch of lumbar vertebrae, is common in Eskimos and some athletes. In Archaic Indians from northwestern Alabama, 17% of males and 20% of females with complete lumbar regions showed this defect. It is found at a fairly early age in adult males in this group, but in females it does not appear until after age 40 years. Spondylolysis is associated with higher levels of osteoarthritis around the fifth lumbar vertebra, where this defect typically occurs. Otherwise, there is little relationship between its presence and degenerative joint disease, especially in the weight-bearing joints. The incidence in young males may be related to activities necessitating a high level of mobility around the lumbar spine. The late occurrence in females suggests that osteoporosis may have been a contributing factor.

Intervertebral osteochondrosis in ancient and modern populations.

Skeletal collections are often useful for determining the frequency and distribution of lesions that would otherwise go unnoticed in the living. This study examines a rather common spinal lesion for which there is little clinical or paleopathologic literature available. In such cases, the anterior aspect of the lower thoracic and lumbar vertebral plates display crescent-shaped lesions suggestive of a form of degeneration known as intervertebral osteochondrosis. A total of 2,628 skeletons from three early American Indian sites and one 20th-century medical-school cadaver population are examined for this lesion. Variables such as age, sex, weight, race, activity patterns, and other biocultural information are considered in relation to the frequency of this lesion. It is suggested that physical stress during the second and third decades of life is largely responsible for this condition. With advancing age the lesions are obliterated and, in effect, become indistinguishable from spondylosis deformans. Familiarity with this condition is necessary in order to better understand degenerative spinal disease and avoid confusion with other spinal diseases such as tuberculosis.

Arthritis in Saxon and mediaeval skeletons.

Examination of 400 Saxon, Romano-British, and mediaeval skeletons from seven archaeological excavations in the west of England showed an unexpectedly high incidence of osteoarthritis and osteophytosis. Three skeletons had evidence of an erosive peripheral arthritis-one with probable gout, one probable psoriatic arthropathy, and one with possible rheumatoid arthritis. The pattern and types of rheumatic disease, and the resultant disability, were apparently different. An exuberant form of large joint osteoarthritis was common and rheumatoid arthritis and similar diseases rare.

[Comparative studies on the frequency of occurrence of degenerative spinal changes in neolithic, medieval and modern man]. / Vergleichende Untersuchungen über die Häufigkeit des Auftretens degenerativer Wirbelsäulen-veränderungen bei Menschen des Neolithikums, des Mittelalters und der Jetztzeit.

105 judgeable spinal columns of neolithic cultures and 11 skeletons from the 11th and 12th century were examined for the presence spondylotic and spondylarthrotic changes of the spinal column taking into consideration the intensity and frequency of affection. With nearly the same affection per individual the frequency of affection in the neolithic population showed significantly lower values with relatively more frequent changes of the cervical vertebral column of the males and greater changes of the lumbar vertebral column in females. The neolithic and medieval group possess a different dependence on age. Apart from this, the medieval group shows an anticipation of the appearance of degenerative changes by about ten years compared with examinations from modern times. The reasons of these differences are discussed.