Lhermitte’s phenomenon

Alternative Name: Barber Chair phenomenon

Definition:

Lhermitte’s phenomenon  is an electrical sensation that runs down the back and into the limbs. In many patients, it is elicited by bending the head forward. It can also be evoked when a practitioner pounds on the posterior cervical spine while the neck is flexed; caused by involvement of the posterior columns

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The Lhermitte’s sign is a symptom rather than a sign as it describes a subjective sensation rather than an objective finding. To add more confusion, it is not attributed to its discoverer. It was first described by Pierre Marie and Chatelin in 1917. Jean Lhermitte did not publish his first report until 1920. However, in 1924 he did publish the seminal article on the subject which resulted in it becoming well known

It’s usually triggered by flexing the neck – that is, bending your head down, chin towards chest. The sensation is short-lived, usually no more than a second.

How often the symptom occurs, and what other symptoms develop along with it, depends on the underlying cause, of which there are several.

Causes:
L’hermitte’s phenomenon is a sign that something may be damaging the spinal cord (especially in the part of it that’s composed of white matter, at the back of the cord). This damage is usually in the neck or region of the spine known as the cervical spine. But the symptom is very non-specific and says nothing about exactly where in the spinal cord the problem is, or what is damaging it.

The most common cause is arthritis of the small joints of the vertebra in that part of the spine, also known as cervical spondylosis. This can cause abnormal pressure on the spinal cord or the nerves coming out of it.

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Other causes include:

•Multiple sclerosis
•Vitamin B12 deficiency (pernicious anaemia)
•Tumours
•Compression of the discs in the cervical spine following trauma
•Radiotherapy to the neck

But in many cases a specific cause for Lhermitte’s phenomenon can’t be found.

Treatment:
It’s important that L’hermitte’s phenomenon is investigated by a specialist to pick up and treat any identifiable cause if possible, and limit or prevent further damage. But in many cases the tests (which may include X-ray of the cervical spine, MRI scans of the brain and cervical spinal cord, lumbar puncture and nerve signal tests known as visual evoked potentials) all come back negative.

When this happens, you should keep an eye on the problem and ask your doctor to repeat the tests if necessary or if symptoms worsen.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose

Resources:
http://en.wikipedia.org/wiki/Lhermitte’s_sign
http://www.bbc.co.uk/health/physical_health/conditions/lhermittes.shtml

http://www.msrc.co.uk/index.cfm/fuseaction/show/pageid/755

http://commons.wikimedia.org/wiki/File:Illu_vertebral_column.jpg

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