Lhermitte’s sign in cavernous angioma of the cervical spinal cord
- Department of Neurology, Lahey Clinic Medical Center, Burlington, Massachusetts
- José A. Gutrecht, MD, Department of Neurology, Lahey Clinic Medical Center, 41 Mall Road, Burlington, MA 01805, USA. Telephone 781 744 8631; fax 781 744 5243.
The sudden feeling of “painless but unpleasant electric shock-like discharges” originating in the neck or upper back and spreading down the spine into the limbs on flexion of the head was first described in 1917 by Marie and Chatelin and later by Lhermitte in his seminal paper of 1924.1 It is not a specific symptom but is most commonly encountered in cervical spinal cord demyelination caused by multiple sclerosis.2 3 The sign has been found in many other conditions that cause a traumatic or compressive cervical myelopathy, such as cervical spondylosis and epidural, subdural, and intraparenchymatous tumours. It has also been reported infrequently in radiation myelitis, pernicious anaemia (subacute combined degeneration), pyridoxine toxicity, nitrous oxide misuse, cisplatin and docetaxel neuropathies, cervical herpes zoster myelitis, paroxetine withdrawal, Behçet’s disease, and systemic lupus erythematosus. Vascular disease of the cervical spine or intraspinal cord has never been noted to produce Lhermitte’s sign.