Morinaga Yusuke, Nii Kouhei, Sakamoto Kimiya, Inoue Ritsurou, Mitsutake Takafumi, Hanada Hayatsura
Department of Neurosurgery, Fukuoka University Chikushi Hospital.
Drug Discov Ther. 2019;13(4):239-243. doi: 10.5582/ddt.2019.01046.
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.
巴雷-利厄综合征是多种自主神经症状及继发症状的表现，如肌肉僵硬、耳鸣、头晕以及头部、颈部、眼睛、喉咙、耳朵、胸部和背部疼痛。虽然认为是由创伤导致自主神经系统过度激活引起，但目前尚无确凿的病因。这一点以及其许多症状的非特异性，给临床医生带来了挑战，他们必须做出正确诊断，同时也给患者带来困扰，患者常常被误诊，或者面临保险公司的无端审查。在此，我们呈现两例巴雷-利厄综合征病例，重点关注诊断过程、治疗及遇到的问题。病例1是一名68岁女性，车祸后头部计算机断层扫描（CT）未显示异常。在初次受伤约10个月后，由于随时间出现的自主神经症状，怀疑患有巴雷-利厄综合征。她服用了一种α受体阻滞剂，9个月后症状缓解。病例2是一名69岁女性，骑自行车时与汽车相撞后出现右胸和右膝瘀伤。1个月后，由于其自主神经症状怀疑患有巴雷-利厄综合征。她服用了一种α受体阻滞剂，17个月后症状缓解。由于上述典型的自主神经症状及继发症状，且对α受体阻滞剂有阳性反应，两例均怀疑为巴雷-利厄综合征。我们相信报告病例将有助于对这种疾病的理解，并帮助患者获得良好的治疗效果。
