Lhermitte's Sign

Original Editor - Shristi Maharjan

Top Contributors - Shristi Maharjan and Kim Jackson  

This article is currently under review and may not be up to date. Please come back soon to see the finished work! (24/11/2021)

Introduction

Lhermitte's Sign is also known as "Lhermitte's Phenomenon", or also referred to as "Barber Chair Phenomenon".

It is described as a transient sensation of an electric shock extending down the spine and/or extremities upon flexion of the neck, often a sequela of neurologic disease. This sensation radiates down the spine, often into the legs, arms, and sometimes to the trunk. It results from the stimulation of irritated nerves or the spinal cord and causes a similar sensation to hitting the elbow or “funny bone.” It is often one of the symptoms that people mention when they’re first diagnosed with multiple sclerosis.

History

Lhermitte's sign was first described by Marie and Chatelin in 1917. The first reference to the symptom was described by Beriel and Devic in 1918 in multiple sclerosis (MS). In 1924, Lhermitte et al. described in detail a patient with MS and electric dysesthesias. Jacques Jean Lhermitte, a forefather of modern clinical neurology, was a French neurologist conducting the majority of his research between 1908 and 1957. Lhermitte was famously recognized for his eponymously named “Lhermitte’s sign.” Lhermitte’s contributions to the field of neurology spanned that of monographic clinical descriptions of syndromes to exquisitely detailed descriptions of neuropathology, finally delving into the realm of modern neuropsychiatry in his later years. Lhermitte laid the groundwork for the burgeoning field of neurology, developing the reputation of a renaissance physician by both his contemporaries and current neurologists. Lhermitte's sign has been associated with the intensity-modulated radiotherapy (IMRT) for head and neck cancer patients. It is one of the late term effects following IMRT in these patients.