Lhermitte's sign

Lhermitte's Sign

Introduction

Lhermitte's Sign (pronounced layr-MEETZ) is a neurological phenomenon characterized by a sensation similar to an electrical shock that radiates down the spine when the neck is bent forward.

Definition and Description

Lhermitte's Sign is described as a transient sensory symptom, often likened to an electric shock, that travels down the back and into the limbs. It typically occurs when the neck is flexed.

Pathophysiology

The sign is believed to result from hyperexcitability of demyelinated nerves in the cervical spinal cord. This demyelination disrupts normal electrical impulse conduction.

Associated Conditions

Lhermitte's Sign can be associated with various neurological conditions, including:

• Multiple sclerosis (MS)
• Cervical spinal cord injuries
• Cervical spondylosis
• Vitamin B12 deficiency

Clinical Significance

The presence of Lhermitte's Sign can be an important diagnostic clue and may aid in the diagnosis of underlying neurological disorders, particularly in the early stages.

Diagnosis and Evaluation

Diagnosis of Lhermitte's Sign is primarily clinical, based on the patient's history and description of symptoms. Neurological examinations and imaging, such as MRI, may be used to investigate underlying causes.

Management and Treatment

Treatment of Lhermitte's Sign focuses on addressing the underlying condition. Symptomatic relief may be achieved through:

• Medications for neuropathic pain
• Physical therapy

Patient Education

Educating patients about Lhermitte's Sign and its implications is crucial, particularly in understanding and managing associated conditions.

References

1. Hadjimichael, O., Kerns, R. D., Rizzo, M. A., et al. (2008). Persistent pain and uncomfortable sensations in persons with multiple sclerosis. Pain, 137(2), 419-431.
2. Al-Shekhlee, A., & Katirji, B. (2003). Lhermitte's Sign in Patients with Multiple Sclerosis. Archives of Neurology, 60(5), 813.

See Also

• Neurological disorders
• Demyelinating disease
• Spinal cord

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