Cervical Instability as a Cause of Barré-Liéou Syndrome and Definitive Treatment with Prolotherapy: A Case Series
European Journal of Preventive Medicine
Volume 3, Issue 5, September 2015, Pages: 155-166
Received: Jul. 20, 2015; Accepted: Aug. 22, 2015; Published: Sep. 14, 2015
Views 14431      Downloads 224
Authors
Ross A. Hauser, Caring Medical and Rehabilitation Services, Oak Park, IL, USA
Danielle Steilen, Caring Medical and Rehabilitation Services, Oak Park, IL, USA
Ingrid Schaefer Sprague, ImageWrite Media, Cleveland, OH, USA
Article Tools
Follow on us
Abstract
Barré-Liéou syndrome, or posterior cervical sympathetic syndrome, has symptomatology related to underlying cervical instability. While classified as a rare disease, Barré-Liéou syndrome is likely underdiagnosed. Vertebral instability, occurring after neck ligament injury, affects the function of cervical sympathetic ganglia (located anterior to vertebral bodies). Symptomatology includes neck pain, migraines/headache, vertigo, tinnitus, dizziness, visual/auditory disturbances, and other symptoms of the head/neck region. Treatment for Barré-Liéou syndrome is suboptimal and often involves long-term use of pain medications, chiropractic care, or surgical fusion. Prolotherapy offers a noninvasive treatment option to ameliorate symptoms while treating the underlying cause of the disorder—cervical instability. In this case series, the results of eight patients from 2011 to 2013 who received prolotherapy for Barré-Liéou syndrome following longstanding symptoms after trauma are reported. All patients reported improvement of neck pain and associated symptoms and increased physical activity. Prolotherapy should be considered as treatment for Barré-Liéou syndrome.
Keywords
Barré-Liéou Syndrome, Cervical Instability, Cervical Spondylosis, Posterior Cervical Sympathetic Syndrome, Prolotherapy
To cite this article
Ross A. Hauser, Danielle Steilen, Ingrid Schaefer Sprague, Cervical Instability as a Cause of Barré-Liéou Syndrome and Definitive Treatment with Prolotherapy: A Case Series, European Journal of Preventive Medicine. Vol. 3, No. 5, 2015, pp. 155-166. doi: 10.11648/j.ejpm.20150305.15
References
[1]
Koleva I, Yoshinov R: Complex rehabilitation programme for amelioration of the quality of life of patients with Barre-Lieou syndrome. Ann Phys Rehab Med 2011, 54S: e107.
[2]
Samy HM, Hamid MA, Friedman M, Egan RA, Manolidis S, Talavera F: Dizziness, vertigo, and imbalance. Medscape 2014, Oct 14. http://emedicine.medscape.com/article/2149881-overview.
[3]
Smitherman TA, Burch R, Sheikh H, Loder E: The prevalence, impact, and treatment of migraine and severe headaches in the United States: a review of statistics from national surveillance studies. Headache 2013, 53(3): 427-436.
[4]
Hain TC: Migraine associated vertigo. American Hearing Research Foundation 2012, October. http://american-hearing.org/disorders/migraine-associated-vertigo-mav/.
[5]
Barré JA: [Sur un syndrome sympathique cervical posterieur et sa cause frequente: L’arthrite cervical]. Rev Neurol 1926, 33:1246–1248.
[6]
Hauser RA, Hauser MA: Prolo Your Sports Injuries Away! Oak Park, IL: Beulah Land Press; 2001.
[7]
Pearce J: Barré-Liéou “syndrome”. J Neurol Neurosurg Psychol 2004, 75(2): 319.
[8]
Tamura T: Cranial symptoms after cervical injury. Aetiology and treatment of the Barré-Lieou syndrome. J Bone Joint Surg Br 1989, 71(2):283-287.
[9]
Hauser RA, Hauser MA: Prolo Your Pain Away! (2nd ed.) Oak Park, IL: Beulah Land Press; 2004.
[10]
Hauser RA, Hauser MA: Prolo Your Headache and Neck Pain Away! Oak Park, IL: Beulah Land Press, 2000.
[11]
Steilen D, Hauser R, Woldin B, Sawyer S: Chronic neck pain: Making the connection between capsular ligament laxity and cervical instability. Open Ortho J 2014, 8:326-345.
[12]
Liéou YC: [Syndrome sympathique cervical posterieur et arthrite cervicale chronique de la colonne vertébrale cervicale Etude clinique et radiologique These de Strasbourg], 1928.
[13]
Boudin G, Barbizet, Pepin B, Fouet P: Syndrome grave da tronc cerebral apres manipulations cervicales [Severe syndrome of the brain stem caused by cervical manipulations]. Bull Mem Soc Med Hop Paris 1957, 73(18-19):562–566.
[14]
Cook JW 4th, Sanstead JK: Wallenberg’s syndrome following self-induced manipulation. Neurology 1991, 41(10):1695-1696.
[15]
Rothrock JF, Hesselink JR. Teacher TM: Vertebral artery occlusion and stroke from cervical self-manipulation. Neurology 1991, 41(10):1696-1697.
[16]
Ernst E: Adverse effects of spinal manipulation: a systematic review. J R Soc Med 2007, 100(7): 330–338.
[17]
Ernst E: Deaths after chiropractic: a review of published cases. Int J Clin Pract 2010, 4(8):1162-1165.
[18]
Ernst E: Vascular accidents after neck manipulation: cause or coincidence? Int J Clin Pract 2010, 64(6):673-677.
[19]
Leon-Sanchez A, Cuetter A, Ferrer G: Cervical spine manipulation: an alternative medical procedure with potentially fatal complications. South Med J 2007, 100(2):201–203.
[20]
Haldeman S, Kohlbeck FJ, McGregor M: Unpredictability of cerebrovascular ischemia associated with cervical spine manipulation therapy: a review of sixty-four cases after cervical spine manipulation. Spine (Phila Pa 1976) 2002, 27(1):49-55.
[21]
Di Fabio RP: Manipulation of the cervical spine: risks and benefits. Phys Ther 1999, 79(1):50-65.
[22]
Qian J, Tian Y, Qiu GX, Hu JH: Dynamic radiographic analysis of sympathetic cervical spondylosis instability. Chin Med Sci J 2009, 24:46-49.
[23]
Li C, Liu X, Ma Z, Yi X: [The effect of cervical spine instability on sympathetic cervical spondylosis]. Zhonghua Wai Ke Za Zhi 2002, 40(10):730-732.
[24]
Wang Z, Wang X, Yuan W, Jiang D: Degenerative pathological irritations to cervical PLL may play a role in presenting sympathetic symptoms. Med Hypotheses 2011, 77(5):921-923.
[25]
Li J, Gu T, Yang H, Liang L, Jiang DJ, Wang ZC, Yuan W, Wang XW: Sympathetic nerve innervation in cervical posterior longitudinal ligament as a potential causative factor in cervical spondylosis with sympathetic symptoms and preliminary evidence. Med Hypotheses 2014, 82(5):631-635.
[26]
Wang XW, Gu T, Yuan W: [Treatment and mechanism of cervical spondylosis with sympathetic symptoms]. Zhonghua Wai Ke Za Zhi 2008, 46(18):1424-1427.
[27]
Quinn KP, Lee KE, Ahaghotu CC, Winkelstein BA: Structural changes in the cervical facet capsular ligament: potential contributions to pain following subfailure loading. Stapp Car Crash J 2007, 51:169-187.
[28]
Panjabi MM, Nibu K, Cholewicki J: Whiplash injuries and the potential for mechanical instability. Eur Spine J 1998, 7(6):484-492.
[29]
Zdeblick TA, Abitbol JJ, Kunz DN, McCabe RP, Garfin S: Cervical stability after sequential capsule resection. Spine (Phila, Pa 1976) 1993, 18(4):2005-2008.
[30]
Rasoulinejad P, McLachlin SD, Bailey SI, Gurr KR, Bailey CS, Dunning CE: The importance of the posterior osteoligamentous complex to subaxial cervical spine stability in relation to a unilateral facet injury. Spine J 2012, 12(7):590-595.
[31]
Ivancic PC, Coe MP, Ndu AB, Tominaga Y, Carlson EJ, Rubin W, Dipl-Ing FH, Panjabi MM: Dynamic mechanical properties of intact human cervical spine ligaments. Spine J 2007, 7(6):659-665.
[32]
Kleinberger M, Sun E, Saunders J, Zhou Zaifei: Effects of Head Restraint Position on Neck Injury in Rear Impact. National Highway Traffic and Safety Administration, Washington, D.C., 2010.
[33]
Panjabi M, Dvorak J, Crisco III JJ, Oda T, Wang P, Grob D: Effects of alar ligament transection upon cervical spine rotation. J Orthop Res 1991, 9(4):584-593.
[34]
Hohl M: Soft tissue injuries of the neck. Clin Orthop Relat Res 1975, 109:42-49.
[35]
Leddy J, Sandhu H, Sodhi V, Baker J, Willer B: Rehabilitation of concussion and post-concussion syndrome. Sports Health 2012, 4(2):147-154.
[36]
Barkhoudarian G, Hovda DA, Giza CC: The molecular pathophysiology of concussive brain injury. Clin Sports Med 2011, 30(1):33-48.
[37]
Swinkels RA, Oostendorp RA: Upper cervical instability: fact or fiction? J Manipul Physiol Therap 1996, 19(3):185-194.
[38]
Hackett GS: Prolotherapy in whiplash and low back pain. Postgrad Med 1960, 27:214-219.
[39]
Havsy SL: Whiplash injuries of the cervical spine and their clinical sequelae Part II. Am J Prev Med 1994, 4(2):73-82.
[40]
Center for Disease Control and Prevention: Injury Prevention and Control: Traumatic Brain Injury. Atlanta, GA: Center for Disease Control and Prevention; 2013. http://www.cdc.gov/traumaticbraininjury/statistics.html.
[41]
Sports Concussion Institute: Concussion Facts. Los Angeles, CA: Sport Concussion Institute; 2012. http://www.concussiontreatment.com/concussionfacts.html.
[42]
Kuether TA, Nesbit GM, Clark VM, Barnwell SL: Rotational vertebral artery occlusion: a mechanism of vertebrobasilar insufficiency. Neurosurgery 1997, 41(2):427-432.
[43]
Yang PJ, Latack JT, Gabrielsen TO, Knake JE, Begarski SS, Chandler WF: Rotational vertebral artery occlusion at C1-C2. AJNR Am J Neuroradiol 1985, 6(1):96-100.
[44]
Endo K, Ichimaru K, Komatagata M, Yamamoto K: Cervical vertigo and dizziness after whiplash injury. Eur Spine J 2006, 15(6):886-890.
[45]
Creighton D, Kondratek, M, Krauss J, Huijbregts P, Qu H: Ultrasound analysis of the vertebral artery during non-thrust cervical translatoric spinal manipulation. J Man Manip Ther 2011, 19(2):84-90.
[46]
Parenti G, Orlandi G, Bianchi M, Renna M, Martini A, Murri L: Vertebral and carotid artery dissection following chiropractic cervical manipulation. Neurosurg Rev 1999, 22(2-3):127-129.
[47]
Mehalic T, Farhat SM: Vertebral artery injury from chiropractic manipulation of the neck. Surg Neurol 1974, 2(2):125-129.
[48]
Mitchell JA: Changes in vertebral artery blood flow following normal rotation of the cervical spine. J Manip Physiol Ther 2003, 26(6):347-351.
[49]
Mitchell J: Vertebral artery blood flow velocity changes associated with cervical spine rotation: a meta-analysis of the evidence with implications for professional practice. J Man Manip Physiol Ther 2009, 17(1):46-57.
[50]
Haynes M, Hart R, McGeachie J: Vertebral arteries and neck rotation: Doppler velocimeter interexaminer reliability. Ultrasound Med Biol 2000, 26(8):57-62.
[51]
Kleynhans AM: The prevention of complications from spinal manipulative therapy. In: Idezk RM, ed. Aspects of manipulative therapy. Proceedings of the Lincoln Institute of Health Sciences Conference. Melbourne, 1980, 133-141.
[52]
Hauser RA: Barré-Liéou syndrome. Get Prolo.com. http://www.getprolo.com/barre-lieou-syndrome/.
[53]
Hauser RA, Hauser MA: Dextrose prolotherapy for unresolved neck pain. Practical Pain Management 2007, 7(8):56-69.
[54]
Centeno CJ, Elliott J, Elkins WL, Freeman M: Fluoroscopically guided cervical prolotherapy for instability with blinded pre and post radiographic reading. Pain Physician 2005, 8(1):67-72.
[55]
Hooper RA, Frizzell JB, Faris P: Case series on chronic whiplash related neck pain treated with intraarticular zygaphophyseal joint regeneration injection therapy. Pain Physician 2007, 10(2):313-318.
[56]
Rotes-Querol J, Crespi PB, Puiggros AC: [Studies on syndromes of the locomotor apparatus of psychic origin. The Barre-Lieou syndrome]. Rev Rhum Mal Osteoartic 1960, 27: 206-213.
[57]
Johansson BH: Whiplash injuries can be visible by functional magnetic resonance imaging. Pain Res Manage 2006, 11(3): 197-199.
[58]
Jónsson H Jr, Bring G, Rauschning W, Sahlstedt B: Hidden cervical spine injuries in traffic accident victims with skull fractures. J Spinal Disord 1994, 4(3): 251-263.
[59]
Kaale BR, Krakenes J, Albrektsen G, Wester K: Head position and impact direction in whiplash injuries: associations with MRI-verified lesions of ligaments and membranes in the upper cervical spine. J Neurotrauma 2005, 22(11): 1294-1302.
[60]
Matsunaga S, Ijiri K, Koga H: Results of a longer than 10-year follow-up of patients with rheumatoid arthritis treated by occipitocervical fusion. Spine (Phila, Pa 1976) 2000, 25(14):1749-1753.
[61]
Ryken TC, Heary RF, Matz PG, Anderson PA, Groff MW, Holly LT, Kaiser MG, Mummaneni PV, Choudhri TF, Vresilovic EJ, Resnick DK, Joint Section on Disorders of the Spine and Peripheral Nerves of the American Association of Neurological Surgeons and congress of Neurological Surgeons: Cervical laminectomy for the treatment of cervical degenerative myelopathy. J Neurosurg Spine 2009, 11(2):142-149.
[62]
Della Pepa GM, Roselli R, La Rocca G, Spallone A, Barbagallo G, Visocchi M: Laminoplasty is better of laminectomy in cervical stenotic myelopathy: myth or truth? Eur Rev Med Pharmacol Sci 2014, 18(1 Suppl):50-54.
[63]
Panchal RR, Duong HT, Shahlaie K, Kim KD: Cervical spinous process reconstruction. J Neurosurg Spine 2014, 20(1):18-21.
[64]
Si Y, Wang Z, Yu T, Lin GZ, Zhang J, Zhang K, Zhang H, Li YC: Results of cervical recapping laminoplasty: gross anatomical changes, biomechanical evaluation at different time points and degrees of level involvement. PloS One 2014, 9(6): e100689.
[65]
Goffin J, Geusens E. Vantomme N, Quintens E, Waerzeggers Y, Depreitere B, Van Calenbergh F, van Loon J. Long-term follow-up after interbody fusion of the cervical spine. J Spinal Disord Tech 2004, 17(2):79-85.
[66]
Hauser RA, Sprague IS: Outcomes of prolotherapy in chondromalacia patella patients: improvements in pain and function. Clin Med Insights Arthritis Musculoskelet Disord 2014, 7:13-20.
[67]
Fullerton BD: High-resolution ultrasound and magnetic resonance imaging to document tissue repair after prolotherapy: a report of 3 cases. Arch Phys Med Rehabil 2008, 89(2):377-385.
[68]
Kayfetz DO, Blumenthal LS, Hackett GS, Hemwall GA, Neff FE: Whiplash injury and other ligamentous headache—its management with prolotherapy. Headache 1963, 3(1):21-28.
[69]
Linetsky FS, Mikulinsky A, Gorfine L: Regenerative injection therapy: history of applications in pain management part I 1930s-1950s. Pain Clin 2000, 2:8-13.
ADDRESS
Science Publishing Group
548 FASHION AVENUE
NEW YORK, NY 10018
U.S.A.
Tel: (001)347-688-8931