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Lhermitte's Sign and EP's
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Lhermitte's Sign and EP's

  Hello, I have a question about Lhermitte's Sign that I experience.  The difference about it is it only happens as I'm falling asleep.  My neck is tilted usually during this time.  It travels from the back of my neck to the bottom of my spine, but it only happens as I'm drifting off to sleep.  It does not happen when I bend my neck down while I'm awake.  Is this something else maybe and not Lhermitte's?  It's the same sensation.  I also get a real "goose-like"  shock sensation in my stomach area.  I guess it's not Lhermitte's because of the area, but it's the same type sensation and also happens as I'm going to sleep.  Could this mean it's an involvement of the brain instead of a cervical lesion?  I am dx. with MS.
  My next question is about the Evoked Potentials.  when I read about them, there is electrodes placed on the forehead.  I've had several of these tests, because of the severe Central Pain in my left arm.  It was dx. as "Central" Pain because this test was normal.  My doc said this means doesn't look like "peripheral" involvement.  There was no electrode placed on my head.  So, the EP tests that come out positive for MS, (not the Visual test, the ones done on the limbs) (sorry, can't think of the right terms right now) I assume are done with the electrodes on the forehead or scalp?  I'm real confused about this.  
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Lhermitte's symptom, as you know, is an electric like shock sensation that travels down the neck and back upon neck flexion. It indicates disease of the posterior part of the cervical spine and is most commonly described in MS and Cervical spine arthritis.  Given your description  and it's occurence when you bend your head at night, it sounds like this is a Lhermitte's.  There is variability - perhaps that's why it's not occuring when your on your feet.
Evoked potentials measuring vision or the brainstem (though hearing sounds) do have electrodes placed on the head.  Somatosensory evoked potentials often do too but your doctor was mainly looking outside the brain and spine.  If he knows that you have MS already, he was probably more interested in examining the nerves in your arm outside the spine.  "Central pain" means pain from the central nervous system, meaning the brain or spine.  Your physician seems to think based on your exam and test findings that this pain is a feature of your multiple sclerosis rather than a new nerve problem say in your arm.




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