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Neurology (Expert Forum)
L'hermitte's Sign
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury.
L'hermitte's Sign
by Susan__0__0, Feb 23, 1998 12:00AM
Posted By CCF NeuroMD/MRR on February 26, 1998 at 08:21:01:
In Reply to: L'hermitte's Sign posted by Susan on February 23, 1998 at 10:34:01:
: I have developed L'hermitte's sign, the electric shock sensation when the neck is bent forward, in the last three months. I feel it is necessary to provide some history of symptoms. In 1994, I developed pain in my right shoulder and down the outside of my right arm. Interestingly, the pain felt better as long as I exercised the arm. X-rays showed nothing wrong, so I was given PT, which helped a lot. Later that year, the same type of pain traveled to my left arm and I also had trouble sleeping because both arms would "fall asleep" and begin to hurt during the night, waking me up several times per night. Sleeping position didn't really matter, it happened no matter how I slept. There has never been any lower arm or hand pain associated with this. Over time, this pain has deminished. In February, 1996, I took a bad fall on some ice and landed on my back. X-rays were taken and everything was pronounced o.k. - I was sore for a few days, but that was it. In January, 1997, I was found to have a T12 spinal nerve root tumor. This was removed without complications and I have experienced no problems with that area of my back. In preparation for the surgery, MRI's (with and without contrast)of the cervical and thoracic spine were done along with a bone scan. Again, the films showed nothing unusual. The only numbness I have during the day, aside from the numb area where the T12 sensory nerve was cut, is my feet fall asleep randomly. It doesn't matter whether I'm sitting or standing, the 3rd and 4th toes mainly go numb and about half the time, the front part of my foot also. (either feet and sometimes both at the same time).
I have had symptoms which could be associated with both lupus and MS at one time or another for most of my life (I am currently age 40), although I never put any symptoms together until a cardiologist who was treating me for a spontaneous coronary artery dissection suggested that we rule out connective tissue diseases as a possible cause for the dissection. A rheumetologist has ruled out lupus and other connective tissue diseases although I have elevated ANAs. I have read information on L'hermitte's and don't know what to do next. Could Spondylosis occur that quickly (within 7 months of the normal MRI's)? Would a lesion from MS show up on those MRI's or develop over 7 months to cause the shock sensations? I guess I am a little frightened and looking for direction. Thanks for any information or suggestions you can give.
In Reply to: L'hermitte's Sign posted by Susan on February 23, 1998 at 10:34:01:
: I have developed L'hermitte's sign, the electric shock sensation when the neck is bent forward, in the last three months. I feel it is necessary to provide some history of symptoms. In 1994, I developed pain in my right shoulder and down the outside of my right arm. Interestingly, the pain felt better as long as I exercised the arm. X-rays showed nothing wrong, so I was given PT, which helped a lot. Later that year, the same type of pain traveled to my left arm and I also had trouble sleeping because both arms would "fall asleep" and begin to hurt during the night, waking me up several times per night. Sleeping position didn't really matter, it happened no matter how I slept. There has never been any lower arm or hand pain associated with this. Over time, this pain has deminished. In February, 1996, I took a bad fall on some ice and landed on my back. X-rays were taken and everything was pronounced o.k. - I was sore for a few days, but that was it. In January, 1997, I was found to have a T12 spinal nerve root tumor. This was removed without complications and I have experienced no problems with that area of my back. In preparation for the surgery, MRI's (with and without contrast)of the cervical and thoracic spine were done along with a bone scan. Again, the films showed nothing unusual. The only numbness I have during the day, aside from the numb area where the T12 sensory nerve was cut, is my feet fall asleep randomly. It doesn't matter whether I'm sitting or standing, the 3rd and 4th toes mainly go numb and about half the time, the front part of my foot also. (either feet and sometimes both at the same time).
I have had symptoms which could be associated with both lupus and MS at one time or another for most of my life (I am currently age 40), although I never put any symptoms together until a cardiologist who was treating me for a spontaneous coronary artery dissection suggested that we rule out connective tissue diseases as a possible cause for the dissection. A rheumetologist has ruled out lupus and other connective tissue diseases although I have elevated ANAs. I have read information on L'hermitte's and don't know what to do next. Could Spondylosis occur that quickly (within 7 months of the normal MRI's)? Would a lesion from MS show up on those MRI's or develop over 7 months to cause the shock sensations? I guess I am a little frightened and looking for direction. Thanks for any information or suggestions you can give.
Doctor's Answer
by CCF neuro MD/MRR, Feb 23, 1998 12:00AM
Dear Susuan,
Hello, the symptoms and history that you have described are not indicative of any
disease in particular. MS is possible, the only way to rule it in is to order MRI of the brain, maybe a
C spine MRI, CSFexam and VEP. These will all help to determine if there is any sign of inflammation consistent
with MS. A neurologist that specializes in MS is the best way to go. Good Luck!
