LHERMITTE SIGN

Course overview

THIS ARTICLE REVIEWS ONE OF THE PAROXYSMAL SYMPTOM/PAIN SYNDROMES, LHERMITTE'S SIGN, A TRANSIENT ELECTRIC SHOCK SENSATION DOWN THE SPINE AND EXTREMITIES CAUSED BY NECK FLEXION. IT IS MOST NOTABLY CAUSED BY MULTIPLE SCLEROSIS (MS) BUT IS CAUSED BY NUMEROUS OTHER LESIONS OF THE POSTERIOR COLUMNS OF THE CERVICAL SPINAL CORD. LHERMITTE'S SIGN IS ALSO CLASSIFIED AS ONE OF THE PAROXYSMAL PAIN SYNDROMES OF MULTIPLE SCLEROSIS, A CHRONIC, PREDOMINANTLY IMMUNE-MEDIATED DISEASE OF THE CENTRAL NERVOUS SYSTEM. IT IS ONE OF THE MOST COMMON CAUSES OF NEUROLOGICAL DISABILITY IN YOUNG ADULTS GLOBALLY AND CAN CAUSE MANY OTHER NEUROLOGICAL CLINICAL SYMPTOMS, INCLUDING MONONUCLEAR PAINFUL VISUAL LOSS, SPINAL CORD HEMIPARESIS, MONO/PARAPARESIS, HYPOESTHESIA, DYSESTHESIA, PARAESTHESIA, URINARY AND/OR SPHINCTER DYSFUNCTION, DIPLOPIA, OSCILLOPSIA, VERTIGO, GAIT ATAXIA, DYSMETRIA, INTENTIONAL/POSTURAL TREMOR, FACIAL PARESIS, FACIOBRACHIAL–CRURAL HEMIPARESIS, AND FACIOBRACHIAL–CRURAL HEMIHYPESTHESIA. THIS ACTIVITY REVIEWS THE DEFINITION, ETIOLOGY, PATHOPHYSIOLOGY, CLINICAL AND PHYSICAL EXAM, CONSIDERATIONS, AND TREATMENTS OF LHERMITTE'S SIGN.