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Lhermitte's sign as a presenting symptom of primary spinal cord tumor

  • Clinical Study
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Summary

We describe a previously healthy 29 year-old man who developed Lhermitte's sign, a shock-like or electric sensation, transmitted down the spine, which occurred during neck flexion or rotation. Evaluation demonstrated an intrinsic, fusiform mass extending from c5 to c7. At operation, the mass was completely removed and found to be a low-grade ependymoma. The sensory phenomena of Lhermitte's sign were most likelycaused by tumor-induced distortion and demyelination of cervical dorsal column sensory axons. Lhermitte's sign is most prevalent in patients with multiple sclerosis, cervical spondylotic myelopathy, cisplatin neurotoxicity, cervical radiation injury, and neck trauma. Rarely, Lhermitte's sign occurs with spinal cord compression from epidural or subdural tumor. This patient is the first reported case of an intrinsic spinal cord tumor to present with Lhermitte's sign.

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References

  1. Marie P, Chatelin C: Sur certains symptomes d'origine vraisemblablment radicularire chez les blesses du crane. Rev Neurol (Paris) 24: 336, 1917

    Google Scholar 

  2. Babinski J, Dubois R: Douleurs a forme de decharge electrique, consecutives aux traumatismes de la nuque. Presse Med 26: 64, 1918

    Google Scholar 

  3. Lhermitte J, Bollak, Nicholas M: Les doulerus a type de decharge electrique consecutives a la flexion cephalique dans la sclerose en plaque. Rev Neurol (Paris) 2: 36–52, 1924

    Google Scholar 

  4. Kanchandani R, Howe JG: Lhermitte's sign in multiple sclerosis: a clinical survey and review of the literature. J Neurol Neurosurg Psychiatry 45: 308–312, 1982

    Google Scholar 

  5. Chan RC, Steinbok P: Delayed onset of Lhermitte's sign following head and/or neck injuries. Report of four cases. J Neurosurg 60: 609–612, 1984

    Google Scholar 

  6. Page NGR, Spiteri MA: Lhermitte's sign in Behçet's disease. Br Med J 284: 704–705, 1982

    Google Scholar 

  7. Walther PJ, Rossitch E, Bullard DE: The development of Lhermitte's sign during cisplatin chemotherapy. Possible drug-induced toxicity causing spinal cord demyelination. Cancer 60: 2170–2172, 1987

    Google Scholar 

  8. Ventafridda V, Caraceni A, Martini C et al.: On the significance of Lhermitte's sign in oncology. J Neuro-Oncol 10: 13–137, 1991

    Google Scholar 

  9. Vollmer TL, Brass LM, Waxman SG: Lhermitte's sign in a patient with herpes zoster. J Neurol Sci 106: 153–157, 1991

    Google Scholar 

  10. Baldwin RN, Chadwick D: Lhermitte's “sign” due to thoracic cord compression. J Neurol Neurosurg Psychiatry 49: 840–841, 1986

    Google Scholar 

  11. Broager B: Lhermitte's sign in thoracic spinal tumour. Personal observation. Acta Neurochirurgica 41: 127–135, 1978

    Google Scholar 

  12. Schliack H, Stille D: Clinical symptomatology of intraspinal tumours. In: Vinken PJ, Bruyn GW (eds) Tumors of the Spine and Spinal Cord, Part 1. Handbook of Clinical Neurology, Vol 19. North-Holland, Amsterdam, 1975, pp 23–49

    Google Scholar 

  13. Sandyk R, Brennan MJW: “Lhermitte's sign” as a presenting symptom of subacute combined degeneration of the cord. Ann Neurol 13: 215–216, 1983

    Google Scholar 

  14. Dewar J, Lunt H, Abernethy DA et al.: Cisplatin neuropathy with Lhermitte's sign. J Neurol Neurosurg Psychiatry 49: 96–99, 1986

    Google Scholar 

  15. Eeles R, Tait DM, Peckham MJ: Lhermitte's sign as a complication of cisplatin-containing chemotherapy for testicular cancer. Cancer Treat Rep 70: 905–907, 1986

    Google Scholar 

  16. Fein DA, Marcus RB, Parsons JT et al.: Lhermitte's sign: Incidence and treatment variables influencing risk after irradiation of the cervical spinal cord. lnt J Rad Oncol Biol Phys 27: 1029–1033, 1993

    Google Scholar 

  17. Newton HB, Newton CL, Gatens C, Hebert R, Pack R: Spinal cord tumors. Review of etiology, diagnosis, and multi-disciplinary approach to treatment. Cancer Practice 3: 207–218, 1995.

    Google Scholar 

  18. Epstein FJ, Farmer JP, Freed D: Adult intramedullary spinal cord ependymomas: The result of surgery in 38 patients. J Neurosurg 79: 204–209, 1993

    Google Scholar 

  19. McCormick PC, Torres R, Post KD, Stein BM: Intramedullary ependymoma of the spinal cord. J Neurosurg 72: 523–532, 1990

    Google Scholar 

  20. Smith KJ, McDonald WI: Spontaneous and mechanically evoked activity due to central demyelinating lesion. Nature 286: 154–155, 1980

    Google Scholar 

  21. Nordin M, Nystrom B, Wallin U et al.: Ectopic sensory discharges and paresthesiae in patients with disorders of peripheral nerves, dorsal roots and dorsal columns. Pain 20: 231–245, 1984

    Google Scholar 

  22. Brieg A: Adverse Mechanical Tension in the Central Nervous System. Wiley & Sons, New York, 1978, pp 17–24

    Google Scholar 

  23. Arasil E, Tascioglu AO: Spontaneous migration of an intracranial bullet to the cervical spinal canal causing Lhermitte's sign. Case report. J Neurosurg 56: 158–159, 1982

    Google Scholar 

  24. Wen PY, Blanchard KL, Block CC et al.: Development of Lhermitte's sign after bone marrow transplantation. Cancer 69: 2262–2266, 1992

    Google Scholar 

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Newton, H.B., Rea, G.L. Lhermitte's sign as a presenting symptom of primary spinal cord tumor. J Neuro-Oncol 29, 183–188 (1996). https://doi.org/10.1007/BF00182142

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  • DOI: https://doi.org/10.1007/BF00182142

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