Lhermitte's sign and vitamin B12 deficiency: case report

Teive, Hélio Afonso Ghizoni; Haratz, Salo; Zavala, Jorge A.; Munhoz, Renato P.; Scola, Rosana Hermínia; Werneck, Lineü Cesar

doi:10.1590/s1516-31802009000300011

Cited by 6 publications

(5 citation statements)

References 22 publications

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“…In addition to paresthesia, this patient experienced muscle spasms, cervical pain, Lhermitte’s sign and hypersomnia. Lhermitte’s sign is one of the rarest manifestations of vitamin B 12 deficiency and is considered a classic sign of multiple sclerosis 21. We recommend clinicians consider B 12 deficiency in patients with Lhermitte’s sign and testing inconsistent with multiple sclerosis.…”

Section: Discussionmentioning

confidence: 98%

Vitamin B₁₂deficiency presenting as neck pain and cervical radiculopathy

Mehta,

Lynch,

Jha

2024

BMJ Case Rep

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Vitamin B12is required for the formation of haematopoietic cells and the synthesis of myelin. Deficiency typically presents with fatigue and megaloblastic anaemia. Prolonged deficiency can cause neurological symptoms such as paresthesia, which can progress to subacute combined degeneration of the spinal cord. We describe an unusual presentation of B12deficiency in a young man who was initially diagnosed and treated for cervical radiculopathy. This case highlights the challenges of diagnosing B12deficiency in patients with neurologic but without haematologic, abnormalities. While the current incidence of B12deficiency in developed countries is low, cases are likely to rise with the increased adoption of veganism. Clinicians should be aware of the variable presentations of B12deficiency because delayed diagnosis and treatment increases morbidity and can cause irreversible neurological deficits.

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Section: Discussionmentioning

confidence: 98%

Vitamin B₁₂deficiency presenting as neck pain and cervical radiculopathy

Mehta,

Lynch,

Jha

2024

BMJ Case Rep

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“…Neck flexion may then result in mechanical deformity of the exposed neurons and produce the characteristic electric shock-like symptom [1,7]. The mechanism by which cisplatin might induce LS is poorly understood.…”

Section: Discussionmentioning

confidence: 99%

Lhermitte's Phenomenon and Platinum, Beware of Latency

O’Reilly

Ryan²,

MacEneaney³

et al. 2014

Oncol Res Treat

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SummaryBackground: Lhermitte's sign (LS) is characterized by electric shock-like sensations, spreading along the spine in a cervico-caudal direction and into the arms and legs. It is felt upon flexion of the neck and reflects a myelopathy resulting from damage to sensory axons at the dorsal columns of the cervical spinal cord. In patients with cancer, LS can occur due to direct tumour involvement of the spine or in relation to radiotherapy. Chemotherapy-related LS has only rarely been reported. Case Report: We present the case of a 44-year-old patient treated with platinum- and etoposide-based chemotherapy for metastatic seminoma, who subsequently developed severe disabling LS. The severity and duration of LS in this case exceeds prior reports. We review the literature on chemotherapy-related LS and discuss the practice implications. Conclusion: Neuropathy and LS related to cisplatin-based chemotherapy can result in significant adverse effects. Raised awareness of this complication could aid sub-phenotyping of the population most at risk and assist strategies to avert discomfort and disability post chemotherapy.

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“…We thank Professor Wiwanitkit for his interest in our case report entitled Lhermitte’s sign and vitamin B12 deficiency: case report. 1 Professor Wiwanitkit raised concerns about the final diagnosis of the case presented in our paper.…”

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confidence: 88%