On the significance of Lhermitte's sign in oncology

Ventafridda, Vittorio; Caraceni, Augusto; Martini, Cinzia; Sbanotto, Alberto; Conno, F. De

doi:10.1007/bf00146874

Cited by 12 publications

(20 citation statements)

References 27 publications

(21 reference statements)

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“…Lhermitte and colleagues subsequently reported a woman with multiple sclerosis in whom LS was one of the presenting symptoms [3]. Since these initial reports, LS continues to be associated most often with multiple sclerosis, but has also been described in many other medical and surgical disease states, including various oncologic conditions [4][5][6][7][8][9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

“…In patients with cancer, LS has been associated with several different conditions, as recently reviewed by Ventafridda et al [8]. It can occur in the context of cancer treatment with cisplatin or radiation therapy [7,8,[14][15][16].…”

Section: Introductionmentioning

confidence: 99%

“…It can occur in the context of cancer treatment with cisplatin or radiation therapy [7,8,[14][15][16]. LS can also be caused by tumors of the cervical or thoracic region that grow in the subdural or epidural space and compress the spinal cord [8,12].…”

Section: Introductionmentioning

confidence: 99%

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

Newton¹,

Rea

1996

J Neuro-Oncol

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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 likely caused 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 patients is the first reported case of an intrinsic spinal cord tumor to present with Lhermitte's sign.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Newton¹,

Rea

1996

J Neuro-Oncol

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“…In cancer patients, LS is recognized as a subacute transient manifestation of myelopathy induced by previous radiotherapy [3]. Lately, it was also reported in cisplatin polyneuropathy [4], after bone marrow transplantation [5] and in neoplastic epidural, spinal cord compression [6].…”

Section: Introductionmentioning

confidence: 99%

“…Thus, it is not surprising that little attention is paid to these sensory symptoms in cancer patients, and that the relevant publications include mostly case reports or a small-scale series [3,[5][6][7][8][9]. Moreover, the details of neurologic evaluation are frequently missing or inadequately recorded [10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Electric shock-like sensations in 42 cancer patients: clinical characteristics and distinct etiologies

Lossos¹,

Siegal

1996

J Neuro-Oncol

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We retrospectively evaluated 42 consecutive cancer patients manifesting electric shock-like sensations. Fourty three percent presented with Lhermitte's sign (LS), 24% with the previously described outstretching ir. abduction maneuver (OAM) of the arms, and 33% had both phenomena. Twenty nine patients had underlying polyneuropathy related to cisplatin-based chemotherapy in 27 and to thiamine deficiency in 2. Thirtreen patients had myelopathy which was induced by radiotherapy in 11. Patients with polyneuropathy manifested both LS and OAM, while patients with myelopathy more often presented with LS. Neurologic signs suggestive of spinal cord involvement were present in 3 patients with polyneuropathy and in 7 of 11 irradiated patients. MRI disclosed cervical spinal cord swelling in 3 patients with LS. Prolonged cervical latencies on SSER were noted in 5 of 15 patients. All had LS and 3 also had OAM associated with abnormal latencies in the brachial plexi. We conclude that LS and OAM are positive sensory manifestations of increased mechanosensitivity of the damaged central or peripheral sensory axons in the cervico-brachial area. In cancer patients, these phenomena largely manifest treatment-induced myelopathy or polyneuropathy. Auxillary studies help to confirm diagnosis and to depict the uncommon but treatable causes.

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