Focus on diagnosis, treatment, and problems of Barré-Lièou syndrome: Two case reports.

Barré-Lièou syndrome is a manifestation of various autonomic and secondary symptoms, such as muscle stiffness, tinnitus, dizziness, and pain in the head, neck, eyes, throat, ears, chest, and back. While thought to be caused by hyperactivation of the autonomic nervous system due to trauma, there is currently no firmly established etiology. This, and the nonspecific nature of many of its symptoms, presents a challenge both for clinicians, who must provide a correct diagnosis and patients, who are often misdiagnosed or faced with undue scrutiny from insurance companies. Here, we present two cases of Barré-Lièou syndrome, focusing on the processes leading to diagnosis, treatment, and problems encountered. Case 1 involves a 68-year-old woman whose head computed tomography (CT) scan revealed no abnormalities following a car accident. Approximately 10 months after her initial injury, Barré-Lièou syndrome was suspected because of autonomic symptoms that developed over time. She was prescribed an α-blocker, and 9 months later, her symptoms subsided. Case 2 was a 69-year-old woman who presented with bruising to the right chest and right knee after colliding with a car while riding her bicycle. One month later, Barré-Lièou syndrome was suspected because of her autonomic symptoms. She was prescribed an α-blocker, and 17 months later, her symptoms subsided. Because of the characteristic autonomic and secondary symptoms described above and a positive response to α-blockers, Barré-Lièou syndrome was suspected in both cases. We believe reporting cases will aid in the understanding of this disease and help patients obtain positive outcomes.

Approach to cervicogenic dizziness: a comprehensive review of its aetiopathology and management.

PURPOSE: Though there is abundant literature on cervicogenic dizziness with at least half a dozen of review articles, the condition remains to be enigmatic for clinicians dealing with the dizzy patients. However, most of these studies have studied the cervicogenic dizziness in general without separating the constitute conditions. Since the aetiopathological mechanism of dizziness varies between these cervicogenic causes, one cannot rely on the universal conclusions of these studies unless the constitute conditions of cervicogenic dizziness are separated and contrasted against each other. METHODS: This narrative review of recent literature revisits the pathophysiology and the management guidelines of various conditions causing the cervicogenic dizziness, with an objective to formulate a practical algorithm that could be of clinical utility. The structured discussion on each of the causes of the cervicogenic dizziness not only enhances the readers' understanding of the topic in depth but also enables further research by identifying the potential areas of interest and the missing links. RESULTS: Certain peculiar features of each condition have been discussed with an emphasis on the recent experimental and clinical studies. A simple aetiopathological classification and a sensible management algorithm have been proposed by the author, to enable the identification of the most appropriate underlying cause for the cervicogenic dizziness in any given case. However, further clinical studies are required to validate this algorithm. CONCLUSIONS: So far, no single clinical study, either epidemiological or interventional, has incorporated and isolated all the constitute conditions of cervicogenic dizziness. There is a need for such studies in the future to validate either the reliability of a clinical test or the efficacy of an intervention in cervicogenic dizziness.

Caso 8. Tumoración del espacio parafaríngeo / Case 8. Tumours of the parapharyngeal space

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[Ocular signs in anterior and posterior cervical sympathetic syndrome].

Features of anatomy and morphological changes of cervical spine resulting in sympathetic innervation defects, blood supply deficiency and ocular symptoms are reviewed. Results of experimental and clinical studies showing correlation of sympathetic cervical ganglions irritation and ocular pathologic conditions are presented. Ocular involvement in neurologic changes in anterior and posterior cervical sympathetic syndrome are reviewed.