Man-in-the-barrel syndrome

Man-in-the-barrel syndrome is a neurological syndrome characterized by bilateral brachial muscular weakness.

Pathology

This syndrome is usually caused by bilateral cerebral lesions in the border zone between the anterior and middle cerebral arteries.

Etiology

The syndrome has been described with multiple cerebral diseases including :

• cerebral hypoperfusion with watershed infarcts
• bilateral cerebral metastases
• bilateral hemorrhagic contusions
• multiple sclerosis

It has also been described with noncerebral diseases such as:

• cervical spinal cord infarction
• osmotic demyelination syndrome
• cervical spondyloarthrosis myelopathy
• bilateral lesions of the brachial plexuses

History and etymology

It was initially described by JP Mohr in 1969 as a brachial diplegia with normal motor function in the legs and face, giving the appearance of being constrained in a barrel .