Jean-Alexandre Barré

Biography

• Born on 25^th May 1880 in Nantes, France
• Worked as an intern with Babinski
• 1912 – Published thesis “Les osteoarthropathies du tabes” (?degenerative osteoarthritis)
• During the first world war was stationed in the neurology centre of the sixth regiment of the French Army where he worked with and befriended George Guillan
• 1919 – Appointed professor of neurology in Strasbourg
• 1950 – Retired
• 1953 – Suffered a stroke leaving him with a hemiparesis
• Died on 26^th April 1967 in Strasbourg, France

Medical Eponyms

Barré sign (1919)

Sign of pyramidal disturbance [*aka manoeuvre de la jambe]. The patient (lying prone) is unable to keep the lower leg vertical on the side of a pyramidal lesion when the knees are flexed.

• Barré JA. La manoeuvre de la jambe. La Presse médicale 1919; 79: 793-795

Guillain- Barré syndrome (1916)

An acute inflammatory paralytic neuropathy [*aka Landry palsy; Landry-Guillain–Barré–Strohl syndrome]

• Guillain G, Barré JA, Strohl A. Sur un syndrome de radiculo-névrite avec hyperalbuminose du liquide céphalo-rachidien sans réaction cellulaire. Remarques sur les caractères cliniques et graphiques des réflexes tendineux. Bulletins et mémoires de la Société médicale des hôpitaux de Paris, 1916; 40: 1462-1470

Barré-Liéou syndrome (1926)

Also known as a posterior cervical sympathetic syndrome. A controversial syndrome which is characteristic by an occipital headache, vertigo, tinnitus and blurred vision which is attributed to irritation of the cervical sympathetic chain by chronic cervical arthritis. First described in 1925 and 1926 by Barré, and further described in 1928 by Yang-Choen Lieou, a student of Barré’s in Strasbourg

• Barré JA. Un nouvel aspect neurologique de l’arthrite cervicale chronique: le syndrome cervicale sympathique poste´rieur. Soc d’ONO Fr de Strasbourg; 1925
• Barré JA. Sur a sympathic cervical syndrome postérieur et sa cause frequent, l’arthrite cervicale. Revue Neurologique. 1926; 1: 1246-1248
• Liéou YC. Syndrome sympathique cervical posterieur et arthrite cervicale chronique de la colonne vertebrale cervicale. Etude clinique et radiologique. These. Strasbourg, 1928

Controversies

Barré test

Despite the relatively prevalent reporting of Barré being one of the first people to describe pronator drift and the use of the term “Barré test” to refer to an arm drift test in the detection of a subtle hemiparesis; this eponym has been incorrectly attributed to Jean Alexander Barré.

It was, Giovanni Mingazzini (1859-1929) in his original paper in 1913 that described this sign as the tendency for downward drift of both the arms and legs when an organic hemiparesis may be present.

The confusion likely arises from Barré’s description within his 1937 paper “Le syndrome pyramidale deficitaire”, where he also used photos demonstrating Mingazzini’s arm and leg tests but without referencing the original article.

In terms of Barré describing a sign relating to the upper limb, in 1920 he did describe “Le signe de l’écartement des doigts” which was a sign relating to the spreading of the fingers of both hands to demonstrate slight paresis

• A. Arm drift test. Mingazzini 1913
• B. Arm test of Mingazzini: from paper by Barré in 1937
• C. Mingazzini leg test: from paper by Barré in 1937
• D. Barré leg test: from paper by Barré in 1937

Major Publications

• Guillain G, Barré JA, Strohl A. Le réflexe médico-plantaire: Étude de ses caracteres graphiques et de son temps perdu. Bulletins et mémoires de la Société médicale des hôpitaux de Paris, 1916; 40: 1459-1462. [Ann Med Interne. 1999;150(1):24-32.]
• Guillain G, Barré JA, Strohl A. Sur un syndrome de radiculo-névrite avec hyperalbuminose du liquide céphalo-rachidien sans réaction cellulaire. Remarques sur les caractères cliniques et graphiques des réflexes tendineux. Bulletins et mémoires de la Société médicale des hôpitaux de Paris, 1916; 40: 1462-1470 [Guillain–Barré syndrome]
• Guillain G, Barré JA. Étude anatomo-clinique de quitanze cas de section totale de la moelle. Ann Méd. 1917; 2: 178–222
• Barré JA. La manoeuvre de la jambe. La Presse médicale 1919; 79: 793-795 [Barré sign]
• Barré JA. Le signe de l’ecartement des doigts. XXIVe Congres des Alienistes et Neurologistes, aout 1920. Revue Neurologique. 1920:942
• Barré JA. Sur a sympathic cervical syndrome postérieur et sa cause frequent, l’arthrite cervicale. Revue Neurologique. 1926; 1: 1246-1248 [Barré – Liéou syndrome]
• Barré JA. Le syndrome pyramidale deficitaire. Revue Neurologique. 1937; 67(1): 1-40 [Barré test]

References

• Mingazzini G. Sur quelques “petits signes” des paresies organiques. Revue Neurologique. 1913; 20(2): 469-473
• Liéou YC. Syndrome sympathique cervical poste´rieur et arthrite cervicale chronique de la colonne verte´brale cervicale. Etude clinique et radiologique. These. Strasbourg, 1928. [Barré – Liéou syndrome]
• Portrait: Jean Alexandre Barré (1880-1967). Spanish Society of Neurology’s museum and historical archive (MAH SEN)
• Fresquet JL. Jean Alexandre Barré (1880-1967). Historia de la Medicina
• Koehler PJ, Bruyn GW, Pearce JMS. Neurological Eponyms. Oxford University Press 2000; 119-126
• Pearce JM. Barré-Liéou “syndrome”. J Neurol Neurosurg Psychiatry 2004; 75(2): 319
• Hirose G. [The Barrés test and Mingazzini test -Importance of the original paper by Giovanni Mingazzini]. Rinsho Shinkeigaku. 2015;55(7):455-8