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Lhermitte's Sign - definition

Lhermitte's Sign "Leur-mits"

Lhermitte’s sign, the phenomenon of an electric shock passing down your spine, and/or into your limbs, can be a feature of central nervous system disease. It is typically triggered by bending the neck forward (putting your chin to your chest). It was named after Jean Lhermitte, a French Neurologist, who established its significance in 1924.

The phenomenon occurs because the back of the spinal cord comes into contact with the spinal canal. This sign is most commonly associated with multiple sclerosis where an inflamed and swollen spinal cord contacts the spinal canal. The sign has been described in a number of other disease of the spinal cord, including cervical spondylotic myelopathy.

Why does it matter in cervical spondylotic myelopathy?

In addition to indicating spinal cord disease, Lhermitte’s sign can be one of the earliest features of cervical spondylotic myelopathy and earlier treatment is more likely to prevent disability. ​

It can be one of the earliest signs of cord compression.

We could think about the following scenario: when the spinal canal starts to narrow, the cord may not be compressed all the time. In fact, the cord might only get squashed when your neck is in certain positions. This ‘dynamic’ process can still cause damage, but to a lesser extent than continuous compression.

Youtube user demonstrating Lhermitte's Sign