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Barre-Lieou Syndrome: Causes, Symptoms & Treatments
Barre-Lieou Syndrome is a condition that is often misunderstood and overlooked, yet it may explain why some patients continue to suffer from chronic headaches, dizziness, facial pain, and neck discomfort even after trying standard treatments.
At Piedmont Physical Medicine & Rehabilitation (PPMR) in Greenville, SC, we specialize in identifying hard-to-find causes of chronic pain, including Barre-Lieou, and creating treatment plans designed to restore function and improve quality of life.
What Is Barre-Lieou Syndrome?
First described in the 1920s by French neurologist Jean Alexandre Barre and Chinese physician Yong-Choen Lieou, this condition involves dysfunction of the posterior cervical sympathetic nervous system — a cluster of nerves located near the vertebrae in the neck.
These nerves are part of the autonomic nervous system, which regulates functions we don’t consciously control, such as blood flow, balance, and pupil response. When the system becomes overactive, it can misfire and create widespread, seemingly unrelated symptoms.
Symptoms of Barre-Lieou Syndrome
Barre-Lieou can cause a broad range of symptoms, which is one reason it is so often missed or misdiagnosed.
Common symptoms include:
Headaches (often behind the eyes or at the base of the skull)
Neck, facial, ear, and even dental pain
Tinnitus (ringing in the ears)
Vertigo (dizziness or balance problems)
Nausea and vomiting
Blurred vision
Watery or tearing eyes
Sinus congestion
Other possible symptoms:
Facial swelling or numbness
Changes in skin color (bluish discoloration)
Hoarseness or changes in voice
Shoulder pain
Tingling or “pins and needles” in the hands and arms
Muscle weakness
Fatigue
Not every patient experiences all symptoms, and they can vary in severity, making diagnosis more difficult.
Not every patient experiences all symptoms, and they can vary in severity, making diagnosis more difficult.
Why Does It Happen?
The sympathetic nervous system is designed to respond to injury or irritation. But in Barre-Lieou, the system becomes “stuck in overdrive.”
Think of it like a car engine that keeps running even after you turn the key off. Instead of calming down once the body heals, the sympathetic nerves remain hyperactive, amplifying pain and sensitivity.
Flare-ups may be triggered by:
Weather changes or barometric pressure shifts
Stress or anxiety
Sinus infections or respiratory illness
Neck injuries, such as whiplash from a car accident
How Is Barre-Lieou Syndrome Diagnosed?
Because symptoms overlap with many other conditions, diagnosis can be challenging. At PPMR, we use a comprehensive evaluation process that may include:
Medical history and physical exam — understanding your full pain story.
Thermography — a specialized, non-invasive test that measures skin temperature patterns, useful for identifying sympathetic nerve dysfunction.
MRI scans — to rule out structural issues in the brain, neck, or spine.
Electrodiagnostic studies (EMG/NCS) — to check for nerve damage and function.
By correlating symptoms with advanced diagnostic tools, we can better determine whether Barre-Lieou Syndrome is contributing to your pain.
Treatment Options for Barre-Lieou Syndrome
The goal of treatment is to restore normal nerve function, improve circulation, and reduce the system’s overall sensitivity. Options may include:
Medications — to reduce inflammation and calm nerve irritation.
Physical therapy — to improve mobility, strengthen support muscles, and ease stress on the cervical spine.
Sympathetic nerve blocks — targeted injections to “reset” overactive nerves and reduce symptoms.
Lifestyle support — addressing stress, posture, and contributing health factors to reduce total load on the system.
Most patients benefit from a multifaceted approach that combines medical treatment with rehabilitative care.
Who Should Be Evaluated for Barre-Lieou?
Barre-Lieou may be worth considering if you have:
Ongoing head and neck pain after an accident (such as whiplash).
Migraines or headaches that don’t respond to standard treatment.
Blurred vision, tinnitus, dizziness, or numbness alongside chronic pain.
Because this condition is often overlooked, it’s important to work with a physician experienced in diagnosing complex pain disorders.
Get Help for Chronic Pain in Greenville, SC
If you’re struggling with persistent headaches, neck pain, dizziness, or tinnitus, and haven’t found lasting relief, Barre-Lieou Syndrome may be the missing piece of the puzzle.
At Piedmont Physical Medicine & Rehabilitation, Dr. Matthew Terzella and our team take the time to listen, look deeper, and uncover the true cause of pain.
