Lhermitte’s Sign

I thought my back was just acting up again, the same as it always was. And per my usual ways, I ignored it. But the feeling persisted. It was an odd feeling, almost electrical, when I would move my head up and down. But again, I ignored it. 

Eventually, I made an appointment with my surgeon who did my back surgery about a year before. I thought I would just get my back checked out again, and hope I wouldn’t need any further treatment. (Boy was I wrong). 

About a week later, my eyes started to get a little blurry too. Odd again, I thought, and again I ignored that too. 

The rest is history. 

What is Lhermitte’s Sign?

Lhermitte’s Sign was first accounted for in 1924 by a French neurologist Jean Lhermitte. Lhermitte had a patient who described various symptoms including poor coordination, stomach pain and an inability to flex her hand (eventually discovered to be Multiple Sclerosis). One of her symptoms was also an electrical sensation that was felt down her neck, which was eventually called Lhermitte’s Sign.

Lhermitte’s Sign is the feeling of an electric shock that travels down the spine, legs, arms and possibly into the trunk when the neck is moved a certain way. The pain is often felt in a very sudden, intense and startling way. Being tired or overheated can bring on the feelings as well (I’m sensing a theme here..). Lhermitte’s Sign is somewhat common in MS, with about 35% of individuals experiencing this feeling at some point. Many times, this can be the first symptom individuals experience as well.

Cause of Lhermitte’s Sign

Lhermitte’s sign can be due to Multiple Sclerosis, but it can be due to other disorders as well including transverse myelitis, behcet’s disease, physical trauma, severe vitamin B12 deficiency or slipped disc, among others. When caused by MS, Lhermitte’s Sign is caused by damage to the nerves in the neck and specifically demyelination of the nerves. When the neck moves, the nerves don’t communicate effectively with the brain, and the brain interprets the movement as pain.

Treatment of Lhermitte’s Sign

Often times Lhermitte’s Sign can go untreated due to it only being present for seconds before abating again. However, there are several treatments available for Lhermitte’s Sign. Medication, adjustments and relaxation techniques are available, so don’t let something that is bothering you just continue! Some medications can be effective because they can lessen the symptoms and help control the nerve pain.

Transcutaneous electrical nerve stimulation (TENS) can also be effective for an individual with Lhermitte’s Sign. A TENS unit will produce electrical charges that reduce inflammation and pain for many conditions. Electromagnetic fields (EMFs) that are directed at an area around the skull have also been proven effective for this as well as other symptoms of MS.

Working with a physical therapist to develop movement strategies that help lessen the pain but still help you go about your day can also be helpful. They can suggest ways to move, stretch and deep breathe to help mitigate your pain. Considering all MS symptoms are aggravated by stress, heat and fatigue, finding ways to manage your stress levels, keep cool and manage your energy levels are key.

Eventually I couldn’t ignore my back anymore, but by that time, my eyes had become too blurry to ignore too. I had to go to the eye doctor first, which led me to the neurologist quite quickly. 

You can read about my story here.

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