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What is Lhermitte"s Sign?

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Updated November 25, 2014.

Lhermitte's sign is an electrical sensation that shoots down the spine from the head towards the feet. It is often brought on by flexing the neck so that the chin moves towards the chest. The sign is thought to indicate dysfunction of the dorsal columns of the cervical spinal cord, which are responsible for transmitting information about light touch, proprioception, and vibration to the brain.

While it has classically been thought of as a sign of multiple sclerosis, Lhermitte's sign can actually be caused by many different problems, including B12 deficiency and transverse myelitis.

Nitrous oxide toxicity can sometimes be associated with a "reverse Lhermitte's sign", in which the electrical sensation travels the opposite direction, from the feet towards the head.

Despite being called "Lhermitte's sign," the first people who described this phenomenon were Pierre Marie and Chatelin in 1917. Jean Lhermitte was a French neurologist who published an article on the subject in 1924, which led to wider knowledge about the symptom.

Sources:

Lhermitte JJ, Bollak NM. Les douleurs à type décharge électrique consécutives à la flexion céphalique dans la sclérose en plaques. Un cas de la sclérose multiple. Revue neurologique 1924; 2:56-57.
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